Skip to main content

Full text of "Medical services; general history"

See other formats


m 




m 



M 



m 



m 



\y^ 



Digitized by the Internet Archive 

in 2012 with funding from 

University of Toronto 



http://archive.org/details/medicalservicesg03macp 






bffiaoj hi&ry Ji* Wo 



TicjOLi nistovy or in*, i vcvr Q 

HISTORY OF THE GREAT WAR 

BASED ON OFFICIAL DOCUMENTS 



MEDICAL SERVICES 
GENERAL HISTORY 



VOL. Ill 



Medical Services during the Operations on 
the Western Front in 1916, 1917 and 1918 ; 
in Italy; and in Egypt and Palestine. 



by 



Major-General Sir W. G. MACPHERSON, 

K.C.M.G., C.B., LL.D. 




I'll 1 ! 






LONDON: 

PRINTED & PUBLISHED BY HIS MAJESTY'S STATIONERY OFFICE 

To be purchased through any Bookseller or directly from H.M. STATIONERY OFFICE 

at the following addresses: Imperial House, Kingsway, London, W.C.2. and 

28, Abingdon Street, London, S.W.i ; York Street, Manchester; 

1, St. Andrew's Crescent, Cardiff; or 120, George Street, Edinburgh. 

I924. 

Price £1 Is. Qd. 



CONTENTS. 



CHAPTER 



I. 

II. 

III. 

IV. 

V. 

VI. 

VII. 

VIII. 

IX. 

X. 

XI. 

XII. 

XIII. 

XIV. 

XV. 

XVI. 

XVII. 

XVIII. 

XIX. 

XX. 



XXI. 



XXII. 



List of Sketch Maps, Charts, etc. 

List of Abbreviations 

Preface 

Minor Actions in 1916 

The Somme Battles of 1916 

The Advance to the Hindenburg Line in 1917 

The Battle of Arras, 1917 

The Battle of Vimy Ridge 

The Flanders Offensives in 1917 

The Battle of Messines 

The Battles of Ypres, 1917 

The Battle of Hill 70, August 1917 

The Dunkirk-Nieuport Area, 1917 

The Cambrai Operations in 1917. . 

The German Offensive in 1918 

The German Offensive against the Fifth Army in 1918 

The German Offensive against the Third Army in 1918 

The German Offensive on the Lys in 1918 

The British Medical Services with the French on the 

Aisne and the Marne, May to August 1918 
The Medical Services during the Advance to Victory 
The Medical Services with the British Forces in Italy 
The Medical Services in Egypt 
The Medical Services during the Operations against 

the Followers of the Senussi and Sultan of Darfur 
The Medical Services during the Operations in the Sinai 

Peninsula 
The Medical Services during the Operations in Palestine 



Appendix A. 1, 



2. 



Medical Units with the British Expeditionary 
Force on the Western Front 



Appendix 
Appendix 



Medical Units with the British Expeditionary 
Force in Italy 
3. Medical Units with the British Expeditionary 
Force in Egypt and Palestine . . 

B. Casualties during the Somme Battles, 1916 

C. Daily Admissions to Field Ambulances and 

Casualty Clearing Stations during the Advance 
to Victory.. 



Index 



PAGE 

iii 

vi 

viii 

1 

11 

54 

65 

95 

112 

120 

137 

172 

175 

183 

201 

212 

232 

249 

273 
291 
327 
362 

394 

409 
436 

485 
507 

510 

522 



528 
541 



SKETCH MAPS. 



Position of Medical Units during Actions at The Bluff, 

March-April 1916 

Medical Situation, 3rd Division and 2nd (Canadian) 

Division. Actions of St. Eloi Craters, March- April 

1916 

Position of Medical Units during German Attack on 

Vimy Ridge, 21st May 1916 

Position of Medical Units during Battle of Mount Sorrel, 

2nd-13th June 1916 

Battle of the Somme. Subsidiary Action at Fromelles, 

July 1916 

Somme Battle Area, 1916 

Battle of the Somme. Situation of Medical Units, 

Fourth Army, on 1st July 1916 
Battle of the Somme. Situation of Medical Units of 

Fourth and Fifth Armies on 30th November 1916 
The Advance to the Hindenburg Line. Ilnd Corps 

Front, April 1917 

Medical Situation of the Battles of Arras and Vimy 

Ridge, April 1917 

Battle of Arras. Vllth Corps Front, April 1917 

Battle of Arras. VI th Corps Front, April 1917 

Battle of Arras, April 1917. Scarpe Valley Operations 

Battle of Vimy Ridge. Canadian Corps Front. . 

Battle of Vimy Ridge. XHIth Corps Front 

Battle of Vimy Ridge. 1st Corps Front 

Battle of Messines, June 1917. General Situation of 

Medical Units, Second Army 
Battle of Messines. Map of Medical Situation, Front 

Area, 36th Division, showing System of Relay Posts . . 
Battles of Ypres, 1917. General Situation of Medical 

Units of Fifth Army on 31st July 1917 
Battles of Ypres, 1917. Medical Organization, Ilnd 

Corps, Front Area, on 31st July 
Battles of Ypres, 1917. Medical Situation, XlXth 

Corps, Front Area, on 31st July 
Battles of Ypres, 1917. Medical Situation, XVIIIth and 

XlVth Corps, Front Area, on 31st July 
Medical Situation on the Coast Area, June-October 

1917. Fourth Army and XVth Corps 
Medical Situation, Battle of Cambrai, November 1917. . 
Medical Situation in the IVth and Illrd Corps during 

the Battle of Cambrai, November 1917 
Sketch Map showing the Relative Positions of Casualty 

Clearing Stations and Hospitals to the Front Line 

during the Period of Defence previous to the German 

Offensive in 1918 

Movement of Casualty Clearing Stations of Fifth Army 

during German Offensive, Spring of 1918 
Movement of Casualty Clearing Stations of Third Army 

during German Offensive, Spring 1918 

(10134) Wt. 2484/5060/141 1500 3/24 Harrow G.45 P.21/4. 





PAGE 


*n text 


2 


,, 


3 


» > 


5 


> > 


7 


To face 


8 
12 


»» 


31 


> » 


33 


In text 


62 


To face 
In text 


66 
72 
76 
91 
97 
101 
105 


To face 


121 


In text 


131 


To face 


139 


In text 


145 


>> 


149 


,, 


152 


To face 


177 
185 



189 

206 
213 
233 



Sketch Maps — continued. 



PAGE 



Movement of Casualty Clearing Stations of First and 
Second Armies during the German Offensive on the 
Lys, 1918 To face 251 

Sketch Map of Medical Situation of French Sixth Army 

on the Aisne, 20th May 1918 , 274 

Medical Situation of the British IXth Corps with the 
French Sixth Army on the Aisne, German Offensive, 
27th May 1918 „ 275 

Sketch Map of the Medical Situation of the British 
IXth Corps with the French Sixth Army on the 
Aisne during the German Offensive, May- June 1918 ,, 277 

Sketch Map showing Positions of Medical Posts of the 
51st and 62nd Divisions (XXIInd Corps) with the 
French Sixth Army, during Operations of July 1918 
on the Eastern Flank of the Marne Salient . . In text 282 

Sketch Map showing Positions of Medical Posts of the 
15th and 34th Divisions with the French Groupe 
d'Armees de Reserve on the Western Flank of the 
Marne Salient during Operations of July 1918 . . ,, 288 

Sketch Map showing the Movements of Casualty 

Clearing Stations during the Advance to Victory . . To face 297 

Medical Arrangements on the Mediterranean Line of 

Communication, French Section . . . . . . „ 328 

Medical Arrangements on the Mediterranean Line of 

Communication, Italian Section . . . . . . ,, 329 

Sketch Map of Positions of Medical Units with British 

Artillery on the Carso Front . . . . . . . . ,, 331 

Medical Situation on the British Lines of Communication 

from the Front in Italy to Marseilles during 1918 . . ,, 335 

Map of Positions of Casualty Clearing Stations on the 

Italian Front „ 340 

Medical Situation in the British XlVth Corps on the 

Asiago Front in June 1918 . . . . . . . . ,, 343 

Medical Situation in the 48th Division during the 

Austrian Offensive of 15th June 1918 . . . . „ 345 

Medical Situation on the Piave Front previous to the 
Advance of the 7th and 23rd Divisions, October- 
November 1918 „ 349 

Medical Situation of the 7th Division at the Passage 

of the Piave in October 1918 „ 350 

Medical Situation of the 23rd Division during the Final 

Operations on the Piave, October 1918 . . In text 352 

Medical Situation during the advance of the 48th 
Division from the Asiago Plateau, October-November 
1918 „ 355 

Map of Egypt, showing Areas of Operations . . . . To face 364 

Operations against the Sultan of Darfur, 1916 . . . . In text 406 

Map of Operations in the Sinai Peninsula . . . . To face 410 

General Map illustrating Operations in Palestine . . ,, 437 

Medical Situation, XXth Corps, 30th October 1917, 

previous to Attack on Beersheba and Sheria . . ,, 448 



Sketch Maps — continued. 

PAGE 

Medical Situation, XXIst Corps, 6th November 1917, 

previous to Capture of Gaza . . . . . . To face 450 

Medical Situation in Palestine at end of 1917 . . . . ,, 453 

Map showing Medical Situation in Palestine previous 

to Final Battles in September 1918 . . . . ,, 457 

Medical Situation during the Raids on Es Salt and 

Amman . . . . . . . . . . . . . . ,, 466 

General Scheme of Evacuation during Pursuit to 

Aleppo . . . . . . . . . . . . In text 481 

CHARTS AND DIAGRAMS. 

Charts showing Movements of Corps and Divisions 

during the Battle of the Somme, 1916 .. .. To face 14 

Chart showing Daily Admissions into Field Ambulances 

for Wounds, Battle of the Somme, 1916 .. .. „ 51 

Chart showing Vacant Beds in L. of C. Hospitals and 
Convalescent Depots in France during the Prepara- 
tions for the Spring Offensive of 1917. . . . . . ,, 56 

Plan of " Thompson's Cave," Battle of Arras, 1917 . . In text 75 

Battle of Arras. Plan of Standard R.A.P. dugout used 

by the 34th Division „ 93 

Battle of Vimy Ridge. Diagram of Xlllth Corps 

Evacuation Organization, April 1917.. .. .. ,, 102 

Diagram showing Xth Corps Scheme of Evacuation 
of Casualties in Preparation for the Battle of 
Messines, June 1917 To face 133 

Scheme of Evacuation of Wounded from the 23rd 

Division during the Battle of Messines . . . . ,, 134 

Scheme of Evacuation of Sick and Wounded from 
IVth and Hlrd Corps during the Battle of Cambrai, 
November 1917 „ 188 

Diagram showing the First and Second Systems of 
using cars of No. 31 Motor Ambulance Convoy with 
the XVIIIth Corps, during German Offensive in 1918 In text 224 

Chart showing Daily Totals of Admissions to Casualty 
Clearing Stations of the First, Second, Third, Fourth 
and Fifth Armies during " The Advance to Victory, 
1918" To face 323 

Chart showing the number of Hospital Beds at the 

Marseilles Base for the British Forces in Italy . . In text 357 

Chart showing the number of Hospital Beds vacant in 
Italy and Marseilles Base, and the number of Sick 
and Wounded awaiting Evacuation from Italy . . To face 360 

Chart showing the Changes which took place in the 
Designations of certain Field Ambulances during the 
Egyptian and Palestine Operations . . . . . . ,, 372 

PHOTOGRAPHS. 

Seventy-nine Photographs illustrating Chapters II-VI, VIII, XV-XIX, 

XXI and XXII. 



VI 



ABBREVIATIONS. 



A.A.M.C. . . Australian Army Medical Corps. 

A.D.G. . . Assistant Director-General. 

A.D.M.S. . . Assistant Director of Medical Services. 

A.D.R.T. . . Assistant Director of Railway Transport. 

A.D.S. . . Advanced Dressing Station. 

A.D.Tn. . . Assistant Director of Transportation. 

A.G. . . Adjutant-General. 

A.M.S. . . Army Medical Service. 

A.O.C. . . Army Ordnance Corps. 

A.Q.M.G. . . Assistant Quartermaster-General. 

A.S.C. . . Army Service Corps. 

A.T. . . Ambulance Train. 

A.V.C. . . Army Veterinary Corps. 

B.R.C.S. . . British Red Cross Society. 

C.A.M.C. . . Canadian Army Medical Corps. 

C.A.S.C. . . Canadian Army Service Corps. 

C.C.H. . . Combined Clearing Hospital. 

CCS. . . Casualty Clearing Station. 

C.F.A. . . Cavalry Field Ambulance. 

CM.D.S. . . Corps Main Dressing Station. 

CP. . . Collecting Post. 

C.W.W.S. . . Corps Walking Wounded Station. 

D.A. & Q.M.G. Deputy Adjutant and Quartermaster-General. 

D.A.D.M.S. . . Deputy Assistant Director of Medical Services. 

D.D.M.S. . . Deputy Director of Medical Services. 

D.D.G. . . Deputy Director-General. 

D.D.G.A.M.S. Deputy Director-General, Army Medical Service. 

D.D.G.M.S. . . Deputy Director-General of Medical Services. 

D.G. . . Director-General. 

D.G.A.M.S. . . Director-General, Army Medical Service. 

D.G.M.S. . . Director-General of Medical Services. 

D.M.S. . . Director of Medical Services. 

D.R.T. . . Director of Railway Transport. 

D.Tn. . . Director of Transportation. 

E.M.O. . . Embarkation Medical Officer. 

E.P.I. P. . . European Privates' Indian Pattern Tent. 

F.A. . . Field Ambulance. 



Vll 



Abbreviations — continued . 



F.A.N.Y. 


First Aid Nursing Yeomanry. 


G.A.R. 


Groupe d'Armees de Reserve. 


G.H.Q. 


. . General Headquarters. 


G.O.C. 


General Officer Commanding. 


G.R.O. 


General Routine Order. 


G.S.O. 


. General Staff Officer. 


I.G.C. 


Inspector-General of Communications. 


I.M.S. 


Indian Medical Service. 


I.S.M.D. 


. Indian Subordinate Medical Department. 


L. of C. 


. Lines of Communication. 


M.A.C. 


Motor Ambulance Convoy. 


M.D.S. 


Main Dressing Station. 


M.O. 


. Medical Officer. 


M.T. 


. Mechanical Transport. 


N.C.O. 


Non-Commissioned Officer. 


N.Y.D.N. 


Not yet diagnosed (nervous) . 


N.Z.M.C. 


New Zealand Medical Corps. 


O.C. 


. Officer Commanding. 


O.R. 


Other Ranks. 


P.B. 


Permanent Base. 


P.D.M.S. 


Principal Director of Medical Services. 


P.U.O. 


Pyrexia of uncertain origin. 


Q.A.I.M.N.S. 


Queen Alexandra's Imperial Military Nursing Service 


Q.M.G. 


Quartermaster-General. 


R.A.F. 


Royal Air Force. 


R.A.M.C. 


Royal Army Medical Corps. 


R.A.P. 


. Regimental Aid Post. 


R.E. 


Royal Engineers. 


R.H.A. 


Royal Horse Artillery. 


R.H.G. 


Royal Horse Guards. 


R.N. 


. Royal Navy. 


R.P. 


Relay Post. 


R.T.O. 


Railway Transport Officer. 


S.A.M.C. 


South African Medical Corps. 


S.M.O. 


. Senior Medical Officer. 


S.O. 


Sanitary Officer. 


T.A.T. 


Temporary Ambulance Train. 


T.F. 


Territorial Force. 


V.A.D. 


Voluntary Aid Detachment. 


W.W.C.P. 


Walking Wounded Collecting Post. 


Y.M.C.A. 


Young Men's Christian Association. 



Vlll 

PREFACE. 

THE chapters in this volume have been compiled mainly 
from the War Diaries and Official Despatches, but 
owing to many of the former being missing, a considerable 
amount of information in connexion with the chapters on 
the medical services in Egypt and during the Sinai and 
Palestine operations has been obtained from officers who 
held administrative medical appointments during these 
operations, chiefly from Major-General Sir R. Ford, who was 
the Director of Medical Services in Egypt, from Sir R. Luce 
and from Lieut. -Colonel J.J. Abraham, the Assistant Director 
of Medical Services on the Palestine Lines of Communication. 

The majority of the small photographs in the text, 
illustrative of various situations of divisional medical services 
on the Western Front, have been obtained from Captain 
R. T. Bruce, who served with a field ambulance of the 51st 
(Highland) Division. Several of the photographs in the text 
of the preceding volume were also obtained from this officer. 

The other photographs are from official sources, several 
of them, notably those in the chapter on the Medical 
Services in Italy, having been supplied by Lieut. -Colon el 
F. S. Brereton, who visited areas of operation with a view 
to obtaining material for the Imperial War Museum and the 
Medical History of the War. 

The compiler is again deeply indebted to Brig.-General 
J. E. Edmonds, the Director of the Military Branch of the 
Historical Section of the Committee of Imperial Defence, 
for his valuable assistance in reading through the manuscript. 

The limitations of time and space, which had been imposed 
for the completion of the Medical History of the War, made 
it difficult to introduce incidents that would render this and 
other volumes more attractive to the general reader. All 
that has been attempted therefore has been to provide a 
basis on which those who are desirous of studying more 
closely the medical situation during the various battles and 
phases of the war may be able to reconstruct with the aid 
of the maps the chief features of the work of the medical 
services. 

General Staff maps, 1 in 250,000, of the Western Front, 
will be found in Volume II of the General History of the 
Medical Services. 

August 1923 W. G. M. 



I 



CHAPTER I. 

MINOR ACTIONS IN 1916. 

N addition to the major operations during the period of 
trench warfare in 1915, described in the preceding volume, 
the medical services were actively engaged in various minor 
operations in the southern area of the Ypres Salient and on 
the Vimy Ridge in the earlier months of 1916. The following 
is a short account of those minor actions, which took place 
before the battles of the Somme in the later months of the year 

Actions of the Bluff. 

During the night of the 14th/ 15th February 1916 the enemy 
exploded a mine on the front of the 17th Division at the Bluff, 
north of St. Eloi ; five sections of trench were lost. Fighting 
was continued on the 16th February, but the counter-attacks 
made to regain the lost ground were unsuccessful. Operations 
then died down until the 1st March, when the 8th Brigade 
of the 3rd Division, with four medical officers and 156 stretcher 
bearers and 1 1 cars, was transferred to the Vth Corps to make 
a combined attack with the 17th Division on the Bluff. The 
attack was made at 4.30 a.m. on the 2nd March and the lost 
ground retaken. Fighting was continued until the 3rd March, 
when the situation again became normal. 

The weather was variable and generally cold, with high 
winds and occasional rain. 

The medical arrangements worked smoothly and well, but 
with considerable losses amongst the personnel. The stretcher 
bearers had great difficulty in bringing back the wounded 
from the regimental aid post and the advanced dressing 
station at Bedford House, a distance of one and a half to one 
and three-quarters of a mile, the only approach being across 
open country which was exposed to heavy shell-fire ; in fact, 
at times bearers attempting to get across were fully employed 
in bringing back their own wounded comrades. The stretcher 
bearers worked steadily day and night and were reinforced 
by the four officers and 156 other ranks of the 3rd Division 
field ambulances. One of the stretcher bearers was killed 
and sixteen wounded. The motor ambulance cars ran up 
through Ypres and down the Lille road to Bedford House. 
They continued running both night and day under frequent 

10134 B 



2 MEDICAL HISTORY OF THE WAR 

and heavy shell-fire. Four of the ambulance cars were damaged 
by shell-fire, and four of the drivers wounded. The positions 
of the various medical posts are shown on the following sketch 
map. 

Position or Medical Units durimq actions at The Bluff, March-April 1916. 



^ResM/v-rt-J^of^oarr. \&Adv.Dr£Ssinq Station. C3 Main Dkessinq Station. 



BrandhOj 




-re— < 



SOWr 



CoJ/et 
Post. 






J7 

Reninghelst 




WPfr. 



<, 



77r"Div. 




In these operations the benefit of the steel helmet, which 
was by this time being issued to the troops, was especially 
brought to notice. Twenty-six cases came under observation, 
in eight of which the helmet had been pierced. In one case 
a shrapnel bullet had penetrated the helmet. It was found 
arrested in the metal, and had produced no wound. In twelve 
cases the helmets had evidently sufficient stopping power to 
prevent a fatal result. In six cases the helmet had been badly 
dented but no injury had been caused. 

At an advanced dressing station of the 17th Division a 
record had been kept of the proportion of lying, sitting and 
walking cases received between 4 a.m. on the 2nd March and 
4 a.m. on the 5th March. The record is of value. It showed 
that the proportion was 240 lying, 438 sitting and 427 walking 
cases. 

There were several casualties from air raids. During one 
of these air raids on the 18th February 1916 a bomb was 
dropped in the Wippenhoek area on the divisional rest station 
of the 50th Division. 



Actions of St. Eloi Craters. 

Between the 27th March and 16th April 1916 there was 
continual fighting in the vicinity of St. Eloi. Several mines had 
been exploded successfully on the 3rd Division front in the early 
morning of the 27th March and about 160 prisoners captured. 



MINOR ACTIONS IN 1916 3 

The 3rd Division continued to hold the positions captured 
until the 5th April, when they were withdrawn to a rest area 
of the Vth Corps on relief by the 3rd Canadian Division. 
This division was attacked on the night of the 5th/6th April , 
and some of the ground which had been taken by the 3rd 
Division was lost. Fighting was continued then in this area 
until the 16th April. 

The following sketch map indicates the positions of the 
medical units during these operations. 



Medical. Situation 3 rd Div. and2 nd (cdn)Div. 
Actions St. Eloi Craters, March-April. 1916. 



4- Rcg.Aio fhsr. Q Advanced DrcsswoSta. fffl Main Dkessins Sta . 



Scafe. ^ 




&&%?** 



iLoCKC. 



St. Jans 



LlNOKNHOeK. 

iDranoutre. 

Z".dfCdn) gnj -w 



The wounded admitted to the field ambulances of the Vth 
Corps between the 27th March and 5th April 1916 numbered 
1,290, of whom 523 were admitted on the 28th March, and 
129 on the following day. 

The 2nd Canadian Division was at the time on the immediate 
right of the 3rd Division, and was the only Canadian division 
that took part in the first phase of the operations. 

The 3rd Canadian Division, which took over the 3rd Division 
front on the 5th April, had arrived in France without its field 
ambulances, but each of the other two divisions of the Canadian 



10134 



B* 



MEDICAL HISTORY OF THE WAR 



Corps, the 1st and 2nd Canadian Divisions, carried on with 
only two field ambulances each and transferred their third 
field ambulance to the 3rd Division. Casualties in the Canadian 
Corps between the 1st and 16th April 1916 were as follows : — 
1st Canadian Division . . . . . . 281 

2nd Canadian Division . . . . . . 917 

3rd Canadian Division . . . . . . 206 



Total 1,404 

The largest number occurred on the 7th April, when 370 
wounded were admitted into the field ambulances. 

German Attack on Vimy Ridge. 

On the 15th May 1916 the 25th Division exploded three 
mines in front of its trenches in the Vimy Ridge area and 
occupied the craters and part of the German trench system in 
that area. This was followed on the afternoon of the 21st 
May by a German counter-attack, preceded by artillery bom- 
bardments during which lachrymatory shells were used, the 
effects of them being felt about three miles behind the front 
line. The counter-attack was made against the junction of 
the First and Third Armies between the Lens-Arras road in 
front of Xeuville St. Vaast, to the south-east of Souchez. 

The 25th Division of the XVIIth Corps (Third Army) 
occupied the right sector in this area, and the 47th Division of 
the IVth Corps (First Army) the left sector. 

The German counter-attack had been successful in capturing 
some of the trenches of this line, and on the afternoon of the 
22nd May 1916 two brigades of the 2nd Division were sent to 
assist the 47th Division in an effort to regain the captured 
trenches on the night of the 22nd/23rd. This attack, however, 
failed to drive the enemy from the captured trenches, and 
the 47th Division was relieved by the 2nd Division on the 
25th May. Wounded admitted to the field ambulances during 
these operations were as follows : — 



Division. 


22nd. 


23rd. 


24th. 


25th. 


47th Division 

2nd Division 

25th Division 


— 


576 
36 

288 


256 

195 

97 


384 
30 
38 


Totals 


— 


900 


548 


452 



MINOR ACTIONS IN 1916 



The positions of the medical units are shown in the following 
sketch map. 

Position of Mecncai. Units during German attack on 
Vimy Ridge SI*:* May 1916. 



+&£6mtl. Aid Post QAov.DnESSiNeSrA. ^MuvDtfssJNeSTA. 




U ' ' LLl ' ? 



^c*fa of mi/cs> 



Co Savins. 



i-ca 4- Vc-.-rrs. 



RoCUNC©U*T. 



Q'v- Qy 3r Au sim. 



Evacuation proceeded steadily and satisfactorily. There 
was no incident requiring special record in connexion with 
these operations, and there were no casualties amongst the 
medical units. 

Battle of Mount Sorrel. 

A battle of greater magnitude was fought between the 2nd 
and 13th June 1916 in the area east of Ypres between the 
Ypres-Comines Canal and the Ypres-Roulers railway, to which 
the name of the Battle of Mount Sorrel has been given. The • 
enemy attacked a line held by the 3rd Canadian Division 
from Mount Sorrel, about 1,000 yards south-east of Zillebeke 
and Hooge, and captured the trenches. A counter-attack 
was made by the 1st Canadian Division and the lost trenches 
were recaptured on the 13th June. The corps engaged was 
the Canadian Corps, with Colonel G. La F. Foster, who arrived 



MEDICAL HISTORY OF THE WAR 



in France as A.D.M.S. of the 1st Canadian Division, as its 
D.D.M.S. The casualties were extremely heavy, especially 
in the 3rd Canadian Division during the first half < ,f the fighting, 
and in the 1st Canadian Division during the second half, as 
is shown in the following table of the numbers received into 
the field ambulances : — 



Division. 


June 
2nd to 8th. 


June 
9th to 15th. 


Total. 


1st Canadian 

2nd Canadian 

3rd Canadian 

Canadian Corps Troops 

20th Division 


1,360 
391 

2,429 
35 
85 


1,567 

419 

273 

18 


2,927 
810 

2,702 
53 
85 


Totals 


4,300 


2,277 


6,577 



This total is made up of 227 officers and 6,350 other ranks. 

The casualties in the medical services were heavy, Lieut.- 
Colonel A. W. Tanner, commanding No. 10 Canadian Field 
Ambulance, being killed, and two other Canadian medical 
officers missing, a quartermaster of No. 8 Canadian Field 
Ambulance wounded, and an officer of No. 1 Canadian Field 
Ambulance evacuated suffering from shell-shock. Four other 
ranks of the R.A.M.C. or C.A.M.C. were killed, thirty of the 
C.A.M.C. wounded, and eight attached drivers of the A.S.C. 
or C.A.S.C. wounded ; two other ranks of the C.A.M.C. were 
also missing. 

Remy Siding had by this time become a large casualty 
clearing station centre, with No. 10, No. 17 and No. 3 (Canadian) 
Casualty Clearing Stations, and the casualties were evacuated 
from the field ambulances to this centre. 

The whole neighbourhood of the advanced dressing station 
at the Asylum, Ypres, was shelled heavily during the evening 
of the 2nd June. Several of the motor ambulance drivers 
and motor cyclists were wounded, and evacuation from the 
Asylum was being retarded. It was decided, consequently, 
to clear direct to the main dressing station at Brandhoek, 
without using this dressing station. It was at this time 
that Lieut. -Colonel Tanner, who was commanding No. 10 Field 
Ambulance in the Asylum dressing station, was fatally 
wounded by a shell while directing the loading of ambulance 
cars in the courtyard. 



MINOR ACTIONS IN 1916 7 

The field ambulances of the 3rd Canadian Division, during 
the first thirty-six hours of this battle, evacuated some 2,000 
cases from the fighting area to the main dressing station at 
Brandhoek, a good record for units so newly arrived in 
France, one of which had never had any experience of front 
line work and had never been under fire previously. 

The work of the motor ambulance drivers was of a very 
arduous nature. The roads were heavily shelled and almost 
impassable in the darkness, but against such odds the men 
continued taking their cars regularly to and fro, and con- 
tributed largely to the successful evacuation of such a large 
number of wounded in so short a space of time. 

Position of Medical Units during Battle of Mount Sorrel, June Z. H ?-lS r ^ \9\6. 



+ ReeMNTL.. Aid Post. Q Adi/awc£o Dressing Station PJJ Main Dk^ssing Station 



*S ld/7i q 




Most of the regimental medical officers had to leave their 
original aid posts, evacuating all their wounded and taking 
up on their own initiative new positions further back, where 
they carried on until the battalions were withdrawn. 

The advanced dressing station of No. 10 Canadian Field 
Ambulance at Maple Copse was under terrific shell-fire. The 
wounded were cleared from it as rapidly as possible and the 
advanced dressing station removed to the Menin Mill, on the 
Menin road, 1,000 yards east of the Menin Gate of Ypres. 
A new advanced dressing station at Zillebeke dugouts was 
also established by the same unit along with No. 9 Canadian 
Field Ambulance, through which some 1,200 to 1,300 cases 
were passed. 

Action at Fromelles. 
While major operations were being conducted in the 
Somme area, the Second and First Armies were engaged 
in a subsidiary action at Fromelles on the Aubers Ridge front 
on the 19th July 1916 



8 



MEDICAL HISTORY OF THE WAR. 



The attack was made about 6 p.m. by the 5th Australian 
Division of the Ilnd Anzac Corps, then in the Second Army, 
in conjunction with the 61st Division of the XI th Corps of 
the First Army on its right. The 5th Australian Division 
had only recently arrived in France from Egypt, where it had 
been organized, and had taken over the line from the 4th 
Australian Division on the 12th of the month. The A.D.M.S., 
Colonel C. H. W. Hardy, had made elaborate arrangements 
for the attack, as shown in the following sketch of the disposition 
of his field ambulances. He had two main dressing stations, 



Battle of the Somme 
Subsidiary action at Fromelles, July 1916 




•fr Zeqmntl.A/dfhst. 

O Adv- Dressing Sta. 

[J Afav'n Dr&ss/ngSta. 



one at Fort Rompu, between Bac St. Maur and Armentieres, 
and the other at a factory at Bac St. Maur> with a series of 
five advanced dressing stations, three of which were advanced 
a few hours after the attack had been launched to positions 
further forward. The motor ambulance cars of the division 
had not arrived by the time of this attack, and 21 motor 
ambulance cars had to be given to it from No. 14 M.A.C. 

Apparently the 61st Division did not advance on the right 
flank as far as did the 5th Australian Division, with the result 
that the latter had a very large number of casualties from 
enfilade fire, several of whom were collected from No Man's 
Land during the days following. 



MINOR ACTIONS IN 1916 



The total casualties in killed, wounded and missing in the 
5th Australian Division amounted to almost 50 per cent, of 
the troops engaged, the figures being as follows : — 





Officers. 


Other ranks. 


Total. 


Killed 

Wounded 
Missing 


30 

45 

102 


476 
1,655 
3,224 


506 
1,700 
3,326 


Total 


177 


5,355 


5,532 



Owing to the small number of casualties on the left flank 
of the division, and their concentration in the centre and right 
flank, the work of the field ambulances and stretcher bearers 
on the right flank became overpowering, and all the available 
personnel and stretchers of No. 8 Australian Field Ambulance, 
which had formed posts on the left flank, were transferred to 
assist on the right flank and centre. The A.D.M.S. of the New 
Zealand Division was also asked to assist, and sent forward 
2 medical officers, 40 other ranks, and 7 motor ambulance 
cars at 12.30 a.m. on the morning of the 20th. 

The officers commanding the field ambulances kept careful 
records of the nature of the wounds, of which the following 
statement is of interest as indicating their location : — 

Percentage of wounds according to locality. 
Head and neck . . .. 16-67 per cent. 



Thorax 


7-93 


Upper extremities 


31-79 


Abdomen 


4-27 


Lower extremities 


31-00 


Back 


2-22 


" Shell Shock " 


6-12 



100-00 

The number of wounded for transport, walking, sitting and 
lying down, was also recorded as follows, between noon on 
19th July and 8 p.m. of 21st July :— 



Field Ambulance. 


Walking. 


Sitting. 


Lying down. 


Total. 


No. 8 Australian . . 
No. 14 
No. 15 


17 

453 
347 


211 
324 
373 


358 
637 
557 


586 
1,414 
1,277 


Total 


817 


908 


1,552 


3,277 



10 MEDICAL HISTORY OF THE WAR 

The number of wounded admitted to the field ambulances 
of the 61st Division was approximately 934. Their collection 
and evacuation were carried out without difficulty and smoothly. 
The stretcher cases were brought to regimental aid posts at 
Red House and Hougomont by regimental stretcher bearers 
on stretchers or wheeled stretcher carriers. The light cases 
went on foot to a collecting station at Laventie East, and were 
taken thence in horse ambulance wagons to a walking wounded 
dressing station at La Gorgue established by a detachment of 
the 2/3rd South Midland Field Ambulance. From there they 
were conveyed in cars of No. 13 M.A.C. to No. 9 and the West 
Riding Casualty Clearing Stations in Lillers, where they 
entrained. The stretcher cases were taken to an advanced 
dressing station at Laventie, and were then removed in the 
motor ambulance cars of the field ambulances to a main 
dressing station at La Gorgue, where a tent division of the 
2/ 1st and 2/3rd South Midland Field Ambulances was employed. 
They were conveyed thence by No. 2 M.A.C. to No. 7 and No. 2 
London C.C.Ss. at Merville for entraining. 

There was no further incident of note during this subsidiary 
action, and the front over which the attack was made became 
quiet immediately afterwards. 



CHAPTER II. 

THE SOMME BATTLES OF 1916. 

THE succession of fiercely fought battles which com- 
menced on the British and French front in the area 
of the Somme and Ancre on the 1st July 1916 lasted until 
towards the end of November. 

The line from which the British divisions launched their 
attack extended from Maricourt Wood, just north of the Somme, 
to Gommecourt, where the enemy's trench line formed a small 
salient. The French held the line on the right from Maricourt 
Wood to the Somme and south of the Somme. The Vllth 
Corps of the Third Army was in front of the Gommecourt 
salient on the left ; but the remainder of the line from Maricourt 
to Hebuterne was held by the Fourth Army, under General 
Sir H. Rawlinson, whose D.M.S. was Surg. -General M. 
O'Keeffe, with Lieut. -Colonel H. B. Fawcus as his A. D.M.S. 

A reserve army, under General Sir Hubert Gough, with 
Surg.-General C. E. Nichol as D.M.S., had its headquarters 
at Daours on the Somme, between Corbie and Amiens, previous 
to the battles.* It consisted at the time the battle commenced 
of the 1st and 3rd Cavalry Divisions and the 2nd Indian 
Cavalry Division only. 

The Fourth Army had five corps in the line. From right 
to left they were the XHIth, under Lieut. -General W. N. 
Congreve, with Colonel G. Cree as his D. D.M.S. ; the XVth, 
under Lieut. -General H. S. Home, with Colonel F. Newland 
as his D. D.M.S. ; the Illrd Corps, under Lieut. -General Sir 
W. P. Pulteney, with Colonel B. M. Skinner as D.D.M.S. ; 
the Xth Corps, under Lieut. -General Sir T. L. N. Morland, 
with Colonel R. Macleod as D.D.M.S. ; and the VHIth, under 
Lieut. -General Sir A. G. Hunter-Weston, with Colonel J. B. 
Wilson as D.D.M.S. 

The Vllth Corps of the Third Army, under Lieut. -General 
Sir T. D'O. Snow, with Colonel W. T. Swan as D.D.M.S., held 
the line from which the attack on the Gommecourt salient 
was to be made. 

* A change in the medical administration of the Reserve, then designated 
the Fifth, Army, took place on the 1st November, when Colonel B. M. Skinner, 
from D.D.M.S. of the Illrd Corps, became the D.M.S. of the Army, with the 
temporary rank of Surg.-General. 



12 MEDICAL HISTORY OF THE WAR 

The XHIth Corps front, with its headquarters at Corbie, 
extended from the wood north-east of Maricourt to the north 
of Caftet Wood, and included the village of Carnoy in its area. 
The divisions holding this line were the 30th (A.D.M.S., Lieut. - 
Colonel J. D. Alexander) and the 18th (A.D.M.S., Lieut. - 
Colonel J. Poe). 

The line of the XVth Corps extended from the left of the 
XHIth Corps south-east of Mametz and Fricourt to a point 
north of Becourt about one and a half miles due east of the 
town of Albert. It was held by the 7th Division (A.D.M.S., 
Lieut.-Colonel A. W. Hooper) and the 21st Division (A.D.M.S., 
Colonel C. W. Profeit). 

The Illrd Corps front on the left of the XVth Corps crossed 
the Albert-Bapaume road just west of La Boisselle to east of 
Authuille. It was held by the 34th Division (A.D.M.S., 
Colonel J. J. Gerrard) and the 8th Division (A.D.M.S., Colonel 
H. N. Dunn). 

From there the line of the Xth Corps ran between Thiepval 
and Thiepval Wood and extended to the right bank of the 
Ancre just north of Llamel. It was held by the 32nd Division 
(A.D.M.S., Colonel P. Evans) and the 36th Division (A.D.M.S., 
Colonel F. J. Greig). 

The line of the VHIth Corps from there ran northwards 
half-way between Beaumont Hamel and Auchonvillers to the 
west of Serre just south-east of Hebuterne. It was held by 
the 29th Division (A.D.M.S., Colonel S. G. Moores), the 4th 
Division (A.D.M.S., Lieut.-Colonel J. Grech) and the 31st 
Division (A.D.M.S., Colonel A. W. Bewley). 

The Vllth Corps held the trenches opposite Gommecourt 
to the south of Monchy au Bois. The divisions in the line 
were the 56th Division (A.D.M.S., Colonel E. G. Browne), 
the 37th Division (A.D.M.S., Colonel R. W. Wright) and the 
46th Division (A.D.M.S., Colonel W. C. Beevor). 

Several other divisions were in reserve, namely the 9th, 17th, 
19th and 12th, 25th and 49th, and the 48th, in the back areas 
of the XHIth, XVth, Illrd, Xth and VHIth Corps. 

Outline of the Battles. 

The attack on the 1st July resulted in the whole system of 
the enemy trenches in front of the XHIth Corps and a portion 
of those between Fricourt and La Boisselle in front of the 21st 
and 34th Divisions being captured and held ; the line was 
thus extended from the Bois de Faviere, north-east of the 
Bois de Maricourt, round Montauban and Mametz to the 



SOMME BATTLE AREA 1916 




M British & French Front Lines 30™ June. 1916. 
— British Line /V ' Jufy 



Qo /-PVu/y ^- 

jO<? /Q t ." September 



British 3 French Lines. /7 T ? November . 
/Vew Broad Gsuge ff&i'/tvay 

Shaded Portion Penates Area of Batt/ e betx££n 

the Jnere an d -t he Somm e 

Scs/e of Miies 



MaJby&Sonslith. 



THE SOMME BATTLES OF 1916 13 

south of Fricourt, and from the north of Fricourt in a salient 
towards the outskirts of Contalmaison to the south of La 
Boisselle. A small salient was also made between La Boisselle 
and Ovillers la Boisselle. Attacks which had been made on 
Fricourt, La Boisselle, Ovillers la Boisselle, Thiepval, Beaumont 
Hamel and Gommecourt failed to attain their objectives. 

Between the 2nd and 13th July the fighting was continued 
until the line was advanced to the edge of Trones Wood and 
along the north of Bernafay Wood, Caterpillar Wood and 
Mametz Wood. Contalmaison and Ovillers la Boisselle were 
also captured and the line continued north of these villages to 
the original line east of Authuille Wood. 

A second advance was made on the 14th July to Delville 
Wood, and included the capture of Longueval, Bazentin le 
Grand and Bazentin le Petit. Fierce fighting then took place, 
with varying results, to secure the high ground extending 
from Guillemont and Ginchy through High Wood to Thiepval. 
These objectives, with the exception of Thiepval, were gained 
by the 12th September, and the line then held by the British 
ran from the west of Combles round Leuze Wood, Ginchy, 
Delville Wood, through High W T ood and westwards along the 
high ground south of Martinpuich and Courcelette and across 
the Albert-Bapaume road north of Pozieres, whence it bent 
back to the original line south of Thiepval. 

The XHIth Corps had been withdrawn from the line on the 
17th August and replaced by the XlVth Corps, under Lieut. - 
General the Earl of Cavan, with Colonel Whaite as D.D.M.S. 
The Divisions in the XlVth Corps at the time were the 56th 
Division (A.D.M.S., Colonel E. G. Browne), the 6th Division 
(A.D.M.S., Colonel B. H. Scott) and the Guards Division 
(A.DM.S., Colonel G. S. McLoughlin). 

On the 15th September the XlVth, XVth and Illrd Corps 
continued the attack, using tanks for the first time. The high 
ground and the reverse slopes north of Ginchy, Flers, Martin- 
puich and Courcelette were gained. The attack was renewed 
on the 25th and 26th September, when Combles, Morval, 
Lesboeufs, Gueudecourt and Thiepval were captured. Subse- 
quent operations between that date and the end of October 
resulted in a line being held from the Bapaume-Peronne road 
at Sailly Saillisel, and from there westwards between Transloy 
and Gueudecourt across the Albert-Bapaume road, just south 
of the Butte de Warlencourt, to Thiepval. 

The Reserve Army which, as already noted, was in the neigh- 
bourhood of Corbie on the 1st July was moved into the area 

(10134) c 



14 MEDICAL HISTORY OF THE WAR 

of the Xth and VHIth Corps on the 6th July and took over 
these corps from the Fourth Army, thus coming in between 
the Fourth Army and the Third Army. It retained the 
designation of the Reserve Army until the 1st November, 
when it was named the Fifth Army. 

The 1st Anzac Corps, under Lieut. -General Sir W. Birdwood, 
with Colonel Manifold, I. M.S. as his D.D.M.S., and composed 
of the 1st, 2nd and 4th Australian Divisions, was added to 
the Reserve Army on the 18th July. The New Zealand 
Division, which had formed part of the Anzac Corps, had been 
withdrawn from it and joined the XVth Corps. The XHIth 
Corps was transferred to General Gough's army on the 17th 
August, and the Xth Corps was withdrawn to Fourth Army 
reserve during the same month. During September the 1st 
Anzac Corps was withdrawn from the Reserve Army and 
replaced by the Canadian Corps, consisting of the 1st, 2nd and 
3rd Canadian Divisions. The 1st Anzac Corps, after a tem- 
porary withdrawal from the Somme area, came back to it at 
the beginning of November and took up a sector on the Fourth 
Army front. 

On the 13th November General Gough's army launched an 
attack on the Ancre at St. Pierre Divion and Beaumont Hamei. 
Both positions were captured. When the battles of the Somme 
and Ancre ceased on the 17th November the line held was 
thus advanced from north of Thiepval across the Ancre just 
west of Grandcourt to the north of Beaucourt-sur-Ancre and 
thence to the original line south-west of Serre. 

In this succession of battles divisions from all sectors of the 
British front took part ; exhausted divisions were withdrawn 
to a reserve corps in rest areas behind the battle front, or to 
quiet areas on other fronts. Fresh divisions took their place, 
and an incessant change and interchange of formations went 
on throughout the whole period. 

The several advances are shown on the map, and the fierce 
character of the attacks and the more or less quiet periods 
between them are well illustrated in the chart (page 51) 
showing the number of the wounded who were received into 
the field ambulances dav by day between the 1st July and 
the 26th November 1916. 

The diagrammatic charts also indicate the constant change 
and interchange of divisions in the various corps engaged and 
the comparative shortness of the time they were in the fighting 
line before being withdrawn, a factor which materially affected 
the medical and sanitary services. 



CHART SHOWING MOVEMENTS OF CORPS AND DIVISIONS DURING 
THE BATTLE OF THE S0MME./9/6. 


FOUR 


LT *i a_ rmv 


UNIT 


JULY 


AUfi. 


sep*; 


OCT. 


NQV- 


DEC. 


jj)M CORPS 
8* Div. 


-2 












12* Div. 


-4 












19* Div. 




• 3 










£3'* Div. 




— /2 


/2— — 


i— IO 






I st Div. 


/O 






i2 3/ 






/5* Div. 
50 th Div. 




5—— 
/7 










47* Div. 




24— 




— 12. 






*■ Div. 








7 ! 


8 




£»» CORPS 


■ 6 












4 th Div. 


— 6 












29* D'V. 


-6 












3/" Div 

48*pjv. 


-6 










3 *6L 

X • "0* *" 

II { | 

■« g '" 2 

.2 o g .2 

Ji • §•! 

0.53-0 
^• B 3 fe 

"lis 

.? ri s 

E u 3' xi 

§ C * O 

■o *" .r £ 

1. a, 

X J X i_> 

h 1- 


0- 

L 
O 


L 
O 

d 


— 


25* Div. 












32"'piv. 


■■6 










S6* Div- 


■ ( 










49* Div. 


■m6 










12* Div. 


4-- 










7* Div. 


2 


/5 


8— 1»7 






15* Div. 


2 


-4 








5* Div. 




1 2? 


28- 


./ 




35-* Div. 




5—'/ 








2 htt I.Cdv.Dtv. 












47* Div. 




f< 23 




lZmmm/9 




2"« Div. 




/3— » ie 








34* Div 




1 8- 20 








20* Div. 




>9»20 




20—24 




55 "'Div. 




.'-; 


30 1 


• 2 




J"" NZ. Div. 




20— 


»3 


6 — 10 




4/ st Div. 




n«-i 


—•7 


/6— 20 




56* Div. 




24— - 


■•4 


/O 24 




6* Div. 




2ft a 


— 7 






/4 th Div. 




30« 


—a/1 






24* Div. 






7 20 






4* Div. 






17—24 






/ 6* Div. 






/9«20 






3Q* Div. 






2(— ■ 


-4 




l«-|.Cav.Div. 






29* 


24 




/ ,r Div. 












2.1* Div. 








3-7 




23-* Div. 








;»— »4 


fl*> Div. 








J4-/6 




13* CORPS 




BMDH/b 








9*Div. 


22 










;$*Piv. 


2/ 










30* Div. 




./ 








3'* Div. 


5~ 


— /6 








35* Div 


J3i 


-«tt-/6 








/ tr Cav. Div 


/3— 23 














2^I.Cav.Div 


/3«— i -23 












2"" Div. 


20 i ■ 


— J2 










55* Div. 


25— 


— — /6 










24* pi v. 
/4* 1 CORPS 


3/< 


/6 










3"* Div. 




/7— 22 










24 rt D»v. 




/7— 24 










35* Div 




; 7»iiimb ' 


.9 








55* Div 




/7«/8 










20* Div 




21 — 




— — — /<* 






5* Div 




25— 


3 


7 






Guards Div. 




26— 




30 






16* Div. 




30« 


■—■17 








56* Div 






5 


— i2 






6* Div. 






3— — 


—24 






4* Div 
2 h *Cav. Div 






25— 


8 


L9 
— 8 




8* Div 
33 rd Dtv. 








;9— 


i>9 
— 8 




/7* Div 
29* Div. 








3/ 







13 2S48C 506 O 



/ lf-1.1500. II. 23 



H M.S.O., Ci 



CHART SHOWING MOVEMENTS OF CORPS AND DIVISIONS DURING 
THE BATTLE. OF THE SOMME.. ISW6 ■ CONTINUED. 



FOURTH ARMY CONTiNUED 



2S£ 



UNIT 



AUG. 



AlfLTi 



tyc CORPS 



y^Div. 



•22 



/yfrpiv. 



^9 23 = 



-/4 



2M c Dt 



4//— (9 



-8 



Div. 



5-/2. 



rA Q-.y.Div 



Ti> 



3L 



^roivA 



J&! 



[£ 



5 tn 0rv. 



■24 



^Div. 



2Q; 



SO )2.— .11 



)4* Div. 



13- 



24 th Div. 



2ff" 



*$*P'v 



.31 



4j£Di 



If 



]» c N.2.D»v. 



aa pi*. 



3£ 



.22 



K)*Div. 



:££ 



>9*Di 



^I.Gxv.Div. 



24- 



lUgrdsDiv 



24. 



P c Div. 



24- 



3J 



20^ Div 



2-4- 



J4_ 



1£ 



24»25 



4* Div. 



30 



60^ Div. 



>23 



6*D. 



20' 



40* Div. 



/^ANZ AC CORPS 



K»I6 



f^Aus Div 



a^Aua.Jiv 



<i—*)8 



20- 



4**^* Div 



J2=iflL 



26: 



5»Attft.Div. 



<4-<8 



27- 



S3 



/7- 



Wcorps 



I7«*D 



2l >c Div. 



/6— 22 



20*2/ 



J£ 



7*Div. 



22*23 



9* Div. 



^3 



23-26 



24 B 'Div. 



/S^Div. 



26- 



^O 



CAVALRY CORre 



3f 



28 



!" $&$*. 



?11>vDiv 



.22 



2>Cav.Diy 



'2 5 



> f >.Cav.Div. 



IS- 



2B 



S^Cav.Div. 

« CORPS 



I3« 



28 



a^coRps 



7f^H 



ga^Div 



36^ Div. 



-4)3»)4 



fc± 



"21^ 



3=^ 



5— JO 



f st Cav.Div . 



3 r * Gov. Div. 



6-9 



J2_ 



f 



<»Div. 



6-9 



Div. 



M" 



*DT 



iO— AS- 



RESERVE CFiFTH) ARMY 



UNIT 



8^ CORPS 



2.9* Div. 



3>'*Div. 



m 



S^Div. 



12* Div. 



38* Div. 



•ggfrQlvT 



10"; CORPS 



a s ', Div 



32"«Div. 



36* Div. 
49* pi v. 



JULY 



S3 



J4 



6-9 



/0- 



.24 



22-25 



?23 



^15_ 



6-9 



^23 



M: 



3i 



SEPT. 



ou 



3 


1 


V 




■5 1 

•- ^- 




o 




-c 




-r( 




* *> 


•j 


*> 




o 


o 


fa 






d 




r 




t- 


■n 


•l 




3 c 


c 


c 




0) 


•) 







"* h 


C 


ifl 




o .2 


f- 






7 * 


■J 


> 




0-1 





-o 




-o 


u 


l- 




•1 


ftl 


o 




*1 




1- 




JJ 

d x 


o 

C 


o 



to 
a 


c d 


d 

en 


ft-' 


3 



C jj 


in 
ft) 

L 

m 


c 




o 






(- 


H 


S £ 


-J— i 






i? 


a) 


a) 


ft) 


-C 


JJ 


j_> 



h 



/Z^ Div 



6— <0 



^g 01 Piv 



10-12. 



ffl& 



IS 



e 



3/ 



13 . 28*8 C . SOSO/ 141 1500 II . 23. 



H.M.SO. Cr 



CHART SHOWING MOVEMENTS OF CORPS AND DIVISIONS DURING 

" the: rattle of the somme 1916 continued 



RESERVE (FIFTH) ARMY C0NTINUE.O. 



m 



7"PT 



AUG. 



He5 



OCT. 



TTovT 



HSZ 



** 



lav. Div, 






i"/\ut.mv. 



Jfi- 



2"*Aus.DivT 



J& 



--3 



4*Aus D'tv. 
2»* C6RPS 



725^0 



24« 



■20 



» Div. 



24— 



£010 



di. 



9» Div. 



24« 



T25 



as"* Div. 



/0 25- 



H* Div. 



«/8 



-2 7 



/3°? Pi* 



/0« 



QQ; Dtv. 



•77 



17' 



•M 



* 



Div. 



72? 



■/5" 



Cdn.Div 



ia- 



3 7 



30" 



JiLPJv 



(7S 



2»« Div- 



as** Div. 



»* W^ 



M g Div. 



—7 



48™ Div 



-2 

[3T 



'* Cav. Div. 



TVS- 



14* CORPS 



29 



i*. 



Div. 



29 



>/6 



i»Div. 



29 



•75 



Gtiorda Div, 



6» Div. 



5*" CORPS 



.16 



1M 



Guards Div. 



16—22 



20 th Div. 



-20 



^r 



7^ 



2~LDi 



39 » Div. 
48^DJy. 



19' 



55 



24' 



78" 



2> 



.££ 



3"» Pi 
5f» c Pi 



!l£. 



;sr 



_JtV 

37°* Div 



i> 



22- 



i)3 



n^oiv. 



<4— 18 



lEvL 



(3- 



2I< 



29 



raw 



PIP 



255 



"25* 



161 



IB- 



'12. 



2a— 2 7 



15= 



"4~8*- 



19"* Div. 



/9« 



lL6_ 



3l' r Div. 



\e 



40* Div. 



7 W L 



J5--I8 



29 



=H 



/« r G£Tuiv. 



120 



28- 



3 rJ Cdn.Div 



4 tK C<in.Div 
4* CORPS 



(0« 



7T 



17 



n<* Div. 



J^CnvDiv 



20- 



25** Div. 



22— il 



40 



» Div. 
^Div. 



J4_ 



^3 



i 



7#* 



-Di\6_ 



24^ 



Div. 



■23 



51* Div 
61 st Div. 



2^ 



"The columns indicate, the, period during which corps were in 

the, army and divisions in the corps. 
The figures against the columns indicate the day of the month 

the corps or division entered or lejt the army or corps. 



f3.m8C 506O//4I . l50O.ll.ei 



H Ml SO.Cr 



THE SOMME BATTLES OF 1916 



15 



The Work of the Medical Services. 

It would not be possible within the limits of space to enter 
into the details of the work of the medical services of each of 
the divisions. The positions occupied by regimental aid posts, 
advanced and main dressing stations of one division were handed 
over to the medical services of the relieving division, and the 
general situation, as regards divisional medical services, was 
thus common to all. The regimental and divisional arrange- 
ments differed but little from those already detailed in con- 
nexion with the battles of 1915, except in so far that the aid posts 
and advanced dressing stations became more and more elaborate 
in construction, in the amount of their accommodation and in 




Entrance to a regimental aid post near Courcelette. 
Ruins of the "Re. I Chateau." 



the shelter provided, and that greater use than ever was made 
of tram lines or light field railways or other means of saving 
hand carriage by the stretcher bearers for bringing back the 
wounded from aid posts to advanced dressing stations. The 
collection and evacuation of wounded followed the general 
principles laid down in the R.A.M.C. Training Manual and in 
Field Service Regulations, but the details of the system had 
been perfected and developed as a result of the experience 
gained in the battles of 1915. The main interest lies in the 
general arrangements that were made for collecting and clearing 
from the divisions the large numbers of wounded who came 
under the charge of the medical services. 

The arrangements may best be described by considering 
each echelon of work separately. 



16 .MEDICAL HISTORY OF THE WAR 

Regimental Medical Service. 

The regimental medical service had no new elements intro- 
duced into it other than those referred to in previous battles. 
As a rule the number of battalion stretcher bearers was increased 
from 16 to 32, and trench stretchers had been authorized in 
addition to the field stretchers. Regimental aid posts were 
invariably in dugouts or in sheltered positions in the communi- 
cation trenches, or in cellars of village houses, many of which 
had been more or less damaged by shell-fire. As a rule the 
wounded were brought back down communication trenches 













L, «r^ 


if wM 






i 

¥ 


-■*' 


Hr ^i 










Bringing in a wounded Prussian artillery officer at Contalmaison. 
Battle of the Somme 1916. 

specially allotted for their evacuation, but in many instances 
these had been damaged and obstructed by shell-fire, and the 
use of wheeled stretcher carriers for bringing back the wounded 
above ground was then found of special value. As the line 
advanced many excellently constructed aid posts were found 
in the enemy's trenches and used as regimental aid posts and 
advanced dressing stations in succession. 

Field Ambulances. 

The work of the bearer divisions of the field ambulances 
was greatly facilitated in some areas by the use of light field 
railways or trolley lines, and also by wheeled stretcher carriers. 
Enemy prisoners of war, in their transit to the rear from the 



THE SOMME BATTLES OF 1916 



17 



positions where they were captured, helped to a considerable 
extent to carry wounded back. The stretchers were replenished 
by the system adopted in the battle of Loos, that is to say they 
were sent up to the field ambulances by the motor ambulance 
convoys from dumps maintained at the casualty clearing 
stations. 

With regard to the positions of advanced dressing stations, 
main dressing stations, and walking wounded collecting posts, 
the factor which chiefly dominated the arrangements was the 
width of the front occupied by divisions and corps. Some of 
these fronts were exceptionally narrow — for example, the front 




Entrance to the advanced dressing station at Bouzincourt. 
Battle of the Somme 1916. 



occupied by the XHIth Corps on the 1st July with two divisions 
in line had a width of about one and a half miles only, and 
that of the Illrd and Xth Corps about two miles. The XVth 
Corps had a wider front, while the VTIIth Corps, which had 
three divisions in line, had a front of about four miles. Conse- 
quently, in preparing for the battle, the XHIth Corps with its 
narrow front arranged to have only one advanced dressing 
station, one walking wounded collecting station, and one 
main dressing station for the corps, these posts being formed 
by the field ambulances of the divisions engaged. The advanced 
dressing station of this corps was at farms on the road between 
Bray and Maricourt ; the collecting post for walking wounded 
being further down the road and just north of Bray ; the 



18 



MEDICAL HISTORY OF THE WAR 



corps main dressing station was just south of the road between 
Bray and Corbie, near the cross roads between Treux on the 
Ancre and Sailly Laurette on the Somme. This latter position 
was known as Dive's Copse* and became an important corps 
main dressing station during the greater part of the operations. 




Interior of advanced dressing station at. Bouzincourt. 
Battle of the Somme 1916. 

The other corps of the Fourth Army at the beginning of the 
operations retained, to a certain extent, the divisional organiza- 
tion of advanced dressing stations and main dressing stations. 
But the advantages of establishing one large corps unit instead 
of divisional units, when divisions were operating within a 
corps on a narrow front, were so well brought out during the 

* Named after Captain Dive, R.A.M.C., No. 96 Field Ambulance, who 
was the first officer in command of this main dressing station. 



THE SOMME BATTLES OF 1916 



19 



work of the medical services in the XHIth Corps in the first 
phase of the battle, that the Fourth Army adopted the system 
for all its corps, and the Director-General for Medical Services 
emphasized this in a memorandum of the 25th July 1916, in 
which he issued an instruction to Ds.M.S. of Armies that when 
corps were operating on a narrow front the work of the main 
dressing stations should be concentrated, as far as possible, 
at some suitable central place in the corps area, and, in order 
to maintain continuity of command and organization, the 
commanding officer of one of the field ambulances, with the 
quartermaster, serjeant-major, and a clerk, should remain in 




Field ambulance at Red Cottage, Fricourt. Battle of the Somme 1916. 



charge and not be changed so long as his field ambulance 
remained in the corps, although it might be withdrawn with its 
division to some other position in the area. 

Consequently the corps main dressing stations in the latter 
part of July were at Dive's Copse for the XHIth, on the right 
bank of the Ancre, between Buire and Dernancourt, for the 
XVth, and at Albert for the Illrd Corps. They remained in 
that position during August, with the exception of the main 
dressing station of the Illrd Corps, which, with its walking 
wounded collecting post, had to be withdrawn from Albert 
to the neighbourhood of Lavieville. In the middle of Sep- 
tember Dive's Copse was closed as a main dressing station 
position and moved forward to the Brav-Maricourt road, and 



20 MEDICAL HISTORY OF THE WAR 

the main dressing station of the XVth Corps was transferred 
to Becordel-Becourt, between Fricourt and Albert. 
* The positions of the main dressing stations of the XVth 
Corps at the beginning of the battle on the 1st July were at 
Morlincourt and Mericourt TAbbe. and of the Illrd Corps at 
Lavieville, Millencourt and Henencourt. The main dressing 
stations of the Xth Corps were at Warloy and Force ville, and 
of the Vlllth Corps at Bertrancourt, Louvencourt, Bus les 
Artois and Couin. 

Advanced operating centres were established by field ambu- 
lances of the Xth Corps in Warloy and of the Vlllth Corps in 




Advanced dressing station of a field ambulance in a shell hole at Fricourt. 
Battle of the Somme 1916. 

Authie, with special surgical teams for the purpose of immediate 
operations on abdominal wounds and other injuries. The 
surgical and nursing staffs of these operating centres, however, 
were not moved with the field ambulance to which they were 
attached for administrative purposes. In the case of the 
advanced operating centre at Authie, it was later on con- 
sidered desirable to place it for administrative control under 
a casualty clearing station instead of under a field ambulance. 
During July as many as three operating surgeons and nine 
nursing sisters were on duty at the operating centre in Warloy. 
It occupied a small but well-built civil hospital with 75 beds, 
supplemented by accommodation for 375 other wounded in 
tents, huts and other buildings. It was taken over by the 



THE SOMME BATTLES OF 1916 21 

medical services of the Unci Corps on the 24th July from the 
Xth Corps ; and on the 1st August a detachment of a casualty 
clearing station (2/ 1st South Midland) was placed in charge 
of it by the D.M.S., Reserve Army. 

The lying down wounded and more severely wounded amongst 
the sitting-up cases were received into the main dressing 
stations, with the exception of those that were sent direct 
by advanced dressing stations to these advanced operating 
centres, but with regard to the lightly wounded, some special 
arrangements were made previous to the battle throughout 
the whole of the Fourth Army area with the object of utilizing 
certain lines of railway for conveying them to the casualty 




Field ambulance cars near Fricourt. Battle of the Somme 1916. 

clearing stations. One broad-gauge strategical line had been 
constructed from Vecquemont on the main line between 
Longeau and Albert northwards through Frechencourt to 
Contay, and another from Candas on the Doullens-Amiens 
line eastwards through Puchevillers and Clairfaye to Acheux. 
A narrow-gauge railway ran from Gezaincourt, one of the 
stations on the Doullens-Amiens line of railway, through 
Beauval to Acheux and onwards to Albert. 

Consequently, in order to utilize these lines of railway for 
lightly wounded, the Illrd Corps established a large collecting 
post and rest station for lightly wounded at Frechencourt, 
where they were entrained for the CCS. at Vecquemont ; 
the Xth Corps a similar post at Vadencourt, near Contay, 



22 




The collecting post of a field ambulance at Auction villers 
before protection by sandbags. 




The same collecting post in process of being protected by sandbags. 



The same collecting post after protection by sandbags. 



THE SOMME BATTLES OF 1916 



23 



and at Clairfaye, where walking wounded were collected for 
entraining at Acheux ; and the VHIth Corps one at Acheux. 

In the later phases of the battles a broad-gauge strategical 
railway, which had been constructed from Dernancourt to 
Maricourt, was also used for clearing lightly wounded from 
corps collecting posts that had been formed in the neighbour- 
hood of Carnoy and Maricourt. 

When the front of the Fourth Army, owing to the area north 
of Albert having been taken over by the Reserve Army on 




The collecting post at Auchonvillers 
after being shelled. 

the 6th July., was contracted approximately from Contal- 
maison to a line facing Guillemont and Trones Wood, 
a distance of between four and five miles, the three 
corps occupying that front at the time, namely, the XlVth, 
XVth and Illrd, had their walking wounded collecting posts 
respectively at Bronfay Farm on the Bray-Maricourt road, 
at Becordel-Becourt, and at Albert. The Illrd Corps 
retained their slightly wounded collecting station at Frechen- 
court, and the Reserve Army similar stations at Vadencourt, 
Clairfaye and Acheux. The walking wounded collecting post 



24 



MEDICAL HISTORY OF THE WAR 



at. Albert, however, became unsafe on account of enemy shell- 
tire, and was withdrawn to a position near Lavieville on the 
Albert road. 




Road from Fricourt to Contalmaison. Battle of the Somme 1916. 



1 




Hnr 1 i 




1 £?'** Hi 


( \h 


C*^ , f) .t> - 


pHBTft^-' ^te ^TB^BBftlfir 11 ' 


' : .. . ■ , 


. ,: 







Advanced dressing station at Contalmaison. Battle of the Somme 1916. 



By the middle of September the walking wounded collecting 
station of the Illrd Corps was advanced to Fricourt, and that 
of the XlVth Corps to the neighbourhood of Carnoy. The Illrd 



THE SOMME BATTLES OF 1916 



25 



Corps then closed its lightly wounded collecting station at 
Frechencourt, but was again obliged to withdraw the post at 
Fricourt to Lavieville. 

The collection of wounded by the field ambulances from the 
regimental aid posts to their advanced dressing stations was 
either by hand carriage, on wheeled stretchers, or on trolley 
lines, but occasionally horsed wagons and motor ambulance 
cars were able to go by night to some of the aid posts or to 
their neighbourhood. In some instances all these methods of 
carrying wounded back were employed on one line of evacua- 
tion ; for example, in the fighting around Courcelette, wounded 




"Armoured" motor ambulance car at Fricourt. 
Battle of the Somme 1916. 

were carried part of the way on trolley lines to the Albert- 
Bapaume road at Pozieres, and transferred there to horsed 
wagons or ambulance wagons, or carried further down the 
valley towards Contalmaison by trolley lines or hand carriage. 
The work of the bearers in this particular sector was especially 
heavy, as in places they had to carry the wounded a distance 
of some 2,000 yards before being able to place them either on 
wheeled vehicles or on trolley lines. From the advanced 
dressing stations to the lightly wounded collecting posts the 
horsed wagons of the field ambulances, or lorries and chara- 
bancs, and in some cases trolley lines, were used, but consider- 
able use was also made of the newly constructed strategical 
railways, especially for bringing back the lightly wounded from 



26 MEDICAL HISTORY OF THE WAR 

the walking wounded collecting posts near Carnoy, Vadencourt 
and Frechencourt to the casualty clearing stations. From 
Clairfaye and Acheux in the northern area the narrow-gauge 
railway was used. 

The ground over which the advance had been made had 
become impossible for wheeled traffic or new tramway lines 
during the latter part of October and beginning of November, 
and the stretcher bearers were then reinforced in some corps, 
notably the XlVth, by men obtained from Pioneer battalions 
and from the divisional trains. Up till then the supply of 
stretcher bearers was adequate so long as the weather continued 




" Armoured " motor ambulance car bstween Fricourt and Contalmaison. 
Battle of the Somme 1916. 

fine. In arranging the relays between Gueudecourt and 
Longueval, the average carry for each relay was 1,000 
yards, and as a rule three relays were required to bring men 
back to the tramway lines. The time taken depended much 
upon the weight of the patient, the strength of the bearers, 
the state of the track as regards mud, and the presence or 
absence of barrage fire. 

The motor ambulance transport of the field ambulances was 
mainly employed in conveying the seriously wounded and lying 
down cases from the advanced dressing stations to the main 
dressing stations, and also direct from the advanced dressing 
stations to the advanced operating centres or to those casualty 
clearing stations allotted for the reception of urgent cases. 



THE SOMME BATTLES OF 1916 



27 







o -P 









Casualty Clearing Stations. 

Sites for casualty clearing stations had been selected and 
prepared previous to the battle close to the broad-gauge 
railway lines, so that ambulance trains could come up direct 
to the casualty clearing stations and evacuate them without 
using cars from the motor ambulance convoys. 



28 



MEDICAL HISTORY OF THE WAR 



Two or more casualty clearing stations were grouped on these 
sites, but carried on their work as independent units, the 




wounded being brought to them in rotation, so that each 
casualty clearing station had only a limited number of wounded, 
varying from 150 to 300, admitted to it at one time. This 



THE SOMME BATTLES OF 1916 29 

enabled the surgical work to be carried on more thoroughly 
and in a more leisurely way than would otherwise have been 
the case, and also gave the officer in charge and the rest of 
his staff an opportunity of having the particulars of each case 
recorded, and proper arrangements made for entraining them 
on the ambulance trains. 

At first the number of casualty clearing stations in the 
Fourth Army permitted of their being grouped in twos only ; 
thus, in the southern part of the area the positions selected 
were along the Amiens-Albert line of railway, namely, at 
Heilly, where Nos. 36 and 38 C.C.Ss. were established, at 
Corbie and La Neuville, a suburb of Corbie, for Nos. 5 and 
21 C.C.Ss., and at Vecquemont, near the junction of the newly 
constructed broad-gauge railway to Contay, where Nos. 34 and 
45 C.C.Ss. were established. 

As ambulance trains were not permitted to run at this time 
on the broad-gauge railway to Contay, no casualty clearing 
stations were established in this central position, although it 
was a very desirable and convenient locality for one or more 
casualty clearing stations. In the northern sector two casualty 
clearing stations were established at Puchevillers (Nos. 3 and 
44), and two in the Citadel at Doullens (Nos. 35 and 11). 

There were single casualty clearing stations at the commence- 
ment of the battle at Gezaincourt (No. 29),* Beauval (No. 4), 
St. Ouen (No. 39) and Amiens (1/lst South Midland). 

All of the casualty clearing stations, with the exception of 
those in the Citadel at Doullens, at Beauval and at Amiens, 
could be cleared direct to ambulance trains without the inter- 
vention of motor transport. No ambulance trains were per- 
mitted to load at the railway station at Amiens, although the 
casualty clearing station there was only one or two hundred 
yards from the railway station. The patients in it had to be 
taken by ambulance car for entraining to Longeau, some three 
miles distant. From Beauval and the Citadel at Doullens 
they were entrained at Gezaincourt, but subsequently arrange- 
ments were made with the Third Army to have the patients in 
the Citadel taken to Doullens railway station for entraining. 
Doullens railway station was some distance from the casualty 
clearing stations and motor ambulance cars or other transport 
were required to bring the wounded to the trains ; but at this 

* An officers' hospital was opened in a large chateau at Gezaincourt , 
to which a special staff of medical officers and nursing sisters was appointed. 
It was under the administrative charge at first of No. 29 C.C.S., but after 
wards of one or other of the casualty clearing stations at Gezaincourt. 

(10134) D 



30 



MEDICAL HISTORY OF THE WAR 



station an excellent refreshment buffet had been established 
by Miss Boot, with the sanction of the French military 
authorities, at the time when Doullens was in the French 
armv area. Miss Boot was permitted to carry on this work 
afterwards when the British took over the area, and was conse- 
quently able to do much for the sick and wounded when they 
arrived at the station pending entraining. 

For Indian troops an Indian cavalry field ambulance was 
opened at the beginning of the operations at Vecquemont, 
but this was replaced very soon by a section of the Lucknow 
Casualty Clearing Station. 













^^ 




W- 1 "^ st 




^? 


\ i - 




g« mmfgf. •*.$$ ^mt-. ^? 


m 


r 




: I 


;<' < ?'! 


■;.■■;.< 


/ 


\*' 


Wtm$ 


/i 



In a casualty clearing station behind the Somme Front 1916. 



The Third Army had two casualty clearing stations in the 
town of Doullens, Nos. 19 and 41. In preparation for the 
battle, the Third Army had also prepared a new site for casualty 
clearing stations on the Doullens-Arras road at a chateau 
and in fields near Solerneau, and close to the railway line at 
the halte for Warlincourt. Two casualty clearing stations were 
placed there, Nos. 20 and 43, and to these casualty clearing 
stations, and to the casualty clearing stations at Doullens, the 
casualties in the attack on Gommecourt Salient were taken. 
In addition to casualty clearing stations in other parts of the 
Third Army area there were stationary hospitals in extensive 
and well-constructed French hospital huts that had been only 
recently erected at Frevent and St. Pol. 



BATTLE OF THE SOMME 

SITUATION OF MEDICAL UNITS 
4- TH ARMY ON l s r JULY 1916 . 

2 3 4-5 

SCALE OF MILES ' ' 



+ ftegi mental^ id Post. 

oil 

Walking Wounded Collecting Station. 



2{&z c t^gPo%r'^ stat ' on or 
Walking Wo- 
Q Main Dressing Station 

Advanced Operative Centre 
Casualty Clearing Station 




lby& Sons Li 



THE SOMME BATTLES OF 1916 31 

There were three casualty clearing stations parked in reserve 
at Etaples, and one of them, No. 47, was brought up to Hesdin 
in the G.H.Q. area during the last week of June in preparation 
for the battle. It was under the direct control of the D.G.M.S. 
It was established in tents on the parade ground there as an 
intermediate post between the front and the Etaples base, in 
the event of its being necessary to send wounded to the base by 
road from casualty clearing stations in the northern area of 
fighting. 

The casualty clearing station at St. Ouen, No. 39, was far 
back, but was retained there for sick and infectious cases. 
Similar arrangements were made in meadows some three 
miles west of Doullens at Recmenil Farm, which at the 
beginning of the battle was occupied by a field ambulance ; 
but on the 6th July a casualty clearing station, the 2/ 1st South 
Midland, was brought up from those in reserve on the L. of C. 
and took over the site. 

Reinforcements. — Immediately after the first attack the need 
of additional casualty clearing stations in the area of the 
Fourth and Reserve Armies became apparent, especially at 
Gezaincourt, which, from the very first day of the battle, 
was flooded with the large number of lightly wounded that 
were brought back to it by the narrow-gauge railway from 
Acheux. Consequently, No. 49 CCS. was hurriedly sent 
there from the L. of C. without its equipment, in order that 
its personnel might assist in the work of No. 29 CCS. The 
personnel arrived on the 3rd July, and the remainder of the 
unit was ordered up on the 6th July. On the 13th July the 
1/lst South Midland CCS. was moved from Amiens to Vecque- 
mont, its place being taken by the New Zealand Stationary 
Hospital which had arrived in France from Egypt, and, on 
the 6th July, the 2/2nd London CCS. was also brought up 
from the L. of C to Heilly. After the first week of July, 
therefore, there was a group of three casualty clearing stations 
at Heilly and at Vecquemont. 

The situation of the casualty clearing stations and their 
number were not altered until August, when it was decided to 
establish casualty clearing stations at Contay, as permission 
had then been received for ambulance trains to run on 
the Contay- Vecquemont line. Consequently, No. 49 CCS. 
was moved on the 12th August from Gezaincourt to 
Contay, and later on No. 9 CCS., on the 14th September, 
was also transferred there from the First Army. No. 49 
CCS. was replaced at Gezaincourt by No. 11 CCS. from the 



32 MEDICAL HISTORY OF THE WAR 

Citadel at Doullens, and at the end of July No. 39 CCS. was 
brought up from St. Ouen to Allonville, between Amiens and the 
headquarters of the Fourth Army at Ouerrieu, where it continued 
to be the unit for the reception of sick and infectious cases. 

In September and October a general advance of casualty 
clearing stations was effected. A site had been selected by 
the side of the new strategical railway line on the plateau 
between Maricourt and Dernancourt, to which the name of 
Grovetown was given. Three casualty clearing stations, the 
2nd London from Heilly, No. 34 from Vecquemont, and No. 48 
from the L. of C were brought up there between the 10th 




No. 45 Casualty Clearing Station at Edgehill, behind the Somme Front. 

and 12th September. A similar site near the Amiens-Albert 
railway line, north of Dernancourt, to which the name of 
Edgehill was given, also became a new casualty clearing 
station position, and No. 45 and the 1/lst South Midland 
Casualty Clearing Stations were brought up to it from Vecque- 
mont, and also No. 13 CCS. from the L. of C The casualty 
clearing station centre at Vecquemont was thus closed by the 
middle of September. In October No. 5 CCS. at Corbie 
was moved to Albert, where, however, it was exposed to hostile 
artillery fire. It was moved to the neighbourhood of Bray 
to a newly constructed French evacuation hospital. 

In the Reserve Army area a new site for three casualty 
clearing stations was selected near the broad-gauge strategical 



BATTLE OF THE SOMME 



SITUATION OF MEDICAL UNITS OF4- T . H &5 T . H ARMIES ON NOVEMBER 30 th 1916. 

5 _2 !f 



SCALE OF MILES 
.2 £__± 2 §_ 



+ Reqi mental Aid Post. + 

£Adv.Dressing Station or Collecting Post €? Casualty Clearing Station 

Walking Wounded Collecting Station. \ 

£3 Main Pressing Station. 



S» Stationary Hospital 

Divisional Pest Station. 
Q Advanced Depot Med Strs. 
Motor Ambulance Convoy. 



British Front Line 
-— French Front Line. 
Army Boundaries 




Malby'iSor.s.Lith 



THE SOMME BATTLES OF 1916 33 

railway at Varennes, south of Acheux, and in the neighbour- 
hood of Clairfaye. No. 4 CCS. from Beauval and No. 11 
CCS. from Gezaincourt were brought up to it early in October, 
No. 4 CCS. being replaced at Beauval by No. 47 CCS. from 
Hesdin, and No. 11 CCS. by No. 3 Australian CCS. from the 
L. of C Later on, in December, Beauval was abandoned 
altogether, and its casualty clearing station, too, was brought 
up to Varennes. In November, No. 35 CCS., from the 
Citadel at Doullens, which remained as the one medical unit 
there, left the Western for the Macedonian front, and the whole 
of the accommodation in the Citadel was then taken over on 
the 13th of the month by No. 3 (Canadian) Stationary Hospital. 
Consequently, when the operations on the Somme front 
ceased, the casualty clearing station situation in the Fourth 
and Fifth Armies was as follows : — 

Fourth Army — 

At Grovetown . . Three casualty clearing stations. 

At Edgehill . . . . Three ,, 

At Heilly . . . . Two 

At Albert . . . . One ,, ,, station. 

At Corbie . . . . One 

At Allonville . . . . One casualty clearing station for 

infectious diseases and other cases 
not requiring evacuation. 

At Amiens . . . . One stationary hospital. 

Fifth Army — 

At Varennes . . Three casualty clearing stations. 

At Contay . . . . Two 

At Puchevillers . . Two 

At Gezaincourt . . Two 

At Recmenil Farm . . One ,, ,, station. 

At Doullens . . . . One stationary hospital. 

No. 19 CCS., in the town of Doullens, had also been placed 
at the disposal of the Reserve Army for the operations on 
the Ancre in November, but was under the administrative 
control of the Third Army. 

Accommodation and Equipment. — Exclusive of the accommo- 
dation for sick and infectious cases at the casualty clearing 
station at St. Ouen and, afterwards, at Allonville, the casualty 
clearing stations of the Fourth Army in July could accommodate 
9,500 wounded, namely, 2,200 at Heilly, 1,550 at Corbie, 
1,600 at Vecquemont, 1,800 at Puchevillers, 1,000 at Gezain- 
court, 400 at Amiens, 450 at Beauval, and 500 in the Citadel 
at Doullens. 



34 MEDICAL HISTORY OF THE WAR 

In order to provide for the additional work at the casualty 
clearing stations, an enormous amount of equipment was added 
not only for medical and surgical purposes, but also in order 
to provide well equipped beds and hospital comforts for the 
more seriously wounded, and better shelter and accommodation. 
Officers commanding casualty clearing stations indented very 
extensively on ordnance stores for additional equipment, and 
the Joint Committee of the B.R.C.S. and Order of St. John, 
which had an advanced store at Recmenil Farm, materially 
assisted in adding to the comfort of the casualty clearingstations. 




Operating theatre in portable hut of a casualty clearing station 
behind the Somme Front. 

Some idea of the extent to which casualty clearing stations 
expanded in this way may be gathered from the fact that, 
when the transfer of casualty clearing stations from Vecque- 
mont to Edgehill and Grovetown took place, the number of 
lorries required to move each of them varied from fifty to 
one hundred. Thus, No. 45 CCS. in moving to Vecquemont 
had one hundred lorry loads of equipment and material. The 
equipment alone amounted to 150 tons, not including some 
huts which had been erected at Vecquemont * When a 
casualty clearing station was moved by rail, generally a whole 

* Twenty of the lorries carried road metal for making roads. This casualty 
clearing station had constructed paths and roads at its site in Vecquemont, 
and took the material up in order to construct similar roads in its new site 
at Edgehill. 



THE SOMME BATTLES OF 1916 



35 



train was required to carry it. As the tonnage of a casualty 
clearing station according to War Establishments is only 
twenty-three tons, capable of being carried on eight 3-ton 
lorries, some idea may be formed of the unwieldy nature of 
casualty clearing stations during this period. Nevertheless 
there was little or no delay in moving them, provided lorries 
and trains were available for the purpose. 

Personnel. — The personnel of casualty clearing stations 
had not been altered from the original War Establishments, 
with the exception of the addition of nursing sisters and dentists. 




Australian wounded being brought to a casualty clearing station. 
Battle of the Somme 1916. 

but it was obvious that with the great increase in the accommo- 
dation of the casualty clearing stations, additional personnel 
would be necessary. These were obtained at first from field 
ambulances of the reserve divisions of corps, each corps providing 
two parties of three officers, three N.C.Os. and twenty men. 
Each of the casualty clearing stations was reinforced by one 
of these parties. In addition, the VHIth and Xth Corps 
detailed two medical officers, two N.C.Os. and eighteen other 
ranks for duty, under the O.C., No. 29 C.C.S., on the trains 
running on the narrow-gauge railway between Acheux and 
Gezaincourt. Each corps had also to detail one officer and 
fifty men temporarily unfit or permanently unfit for duty in 
the fighting line to each of the casualty clearing stations for 
fatigue work and for loading and unloading ambulance cars 
and ambulance trains. 



36 MEDICAL HISTORY OF THE WAR 

At the commencement of the battles of the Somme, Surg.- 
General Sir Anthony Bowlby was stationed at No. 38 CCS., 
Heilly, and acted as consulting surgeon for the group of casualty 
clearing stations in the southern area of the Fourth Army, 
while the consulting surgeon of the Army, Colonel T. Sinclair, 
was stationed at No. 3 CCS. at Puchevillers as consulting 
surgeon for the group of casualty clearing stations in the 
northern area. Colonel Sir Wilmot Herringham also went 
from G.H.Q. to No. 36 CCS., Heilly, as a consulting physician 
in connexion with wounds of the chest. Sir Anthony Bowlby 
returned to G.H.Q. on the 23rd July, and Colonel Sinclair 
then rejoined the Fourth Army Headquarters at Querrieu. 
On the 30th August Colonel Maynard-Smith was appointed 
consulting surgeon to the Reserve Army, but until he took 
up his duties Sir Anthony Bowlby acted as consulting surgeon 
to the Army, supervising the surgical work in it from G.H.Q. 

In anticipation of the fighting in the Fifth Army on the 
13th November, Colonel C Wallace, consulting surgeon of 
the First Army, was temporarily attached to the casualty 
clearing stations at Puchevillers and Contay, and Colonel 
Maynard-Smith to those at Varennes. 

Considerable additions were also made to the personnel 
of the casualty clearing stations immediately after the initial 
attack. The D.G.M.S. arranged on the 3rd July for the D.M.S., 
L. of C, to send fifty emergency stretcher bearers from the 
R.A.M.C Reserve Bearer Company at Boulogne to No. 36 
CCS., fifty to No. 34 at Vecquemont, and forty R.A.M.C 
other ranks from No. 29 Field Ambulance, which was then in 
reserve on the L. of C, to No. 3 CCS., followed by twenty 
nursing orderlies of the same field ambulance to each of the 
casualty clearing stations at Heilly. 

A number of surgical teams, each consisting of one specialist 
surgeon, one anaesthetist, one nursing sister and one operating 
room attendant, was sent from the First and Second Armies. 
On the 2nd July two of these teams were sent to Vecquemont, 
two to Heilly, one to Amiens, two to Puchevillers and two to 
Corbie. On the 17th July a still further reinforcement of 
surgeons was obtained from casualty clearing stations in the 
Third Army, namely, two for No. 23 CCS., two for No. 45 
CCS. at Vecquemont, and two for No. 36 CCS. at Heilly. 

The increase in this way of surgical personnel led to a con- 
siderable advance in the surgical work performed in casualty 
clearing stations.* Casualty clearing stations which were only 

* See Chapter XI, Surgery of the War, Vol. I. 



THE SOMME BATTLES OF 1916 



37 



receiving lightly wounded did not, however, have an addition 
to their surgical staff. In others the number of medical officers 
was practically doubled.* 

A curious incident occurred in No. 21 CCS. at La Neuville, 
near Corbie, which is of some historical interest. A N.CO. 
of the R.A.M.C on duty with the unit created much excite- 
ment by what appeared to be a method discovered by himself 
of delineating the internal organs by means of electric currents 
passed through the body. His work was studied by consulting 
surgeons and others, whom he completely deceived, and notices 
appeared in medical journals of this apparently important 
advance in medical science. | Later on, during the battle, 
he began to produce what appeared to be photographs taken 
by wireless methods. His photographs showed enemy aero- 
planes and airships travelling over Corbie by night at a time 
when a raid was expected. A still further advance in his 
activities was made when he announced that he had discovered 
a method of destroying life at a distance by electric power. 
He was then given every facility for carrying on his experiments, 
and eventually he was placed under the direct supervision 
of the General Staff and their expert electric advisers, in an 
enclosure at No. 12 Stationary Hospital, St. Pol. The final 
result was that the whole of his experiments were proved to 
be fraudulent. The N.CO. was placed under arrest and tried 
by court martial. 

Disposal of Casualties. — The distribution of wounded and 
sick to the casualty clearing stations was determined by the 
D.M.S. of the Army, who issued instructions for the disposal 
of the wounded as follows : — 

Seriously Wounded. 
From Xlllth Corps to No. 21 CCS. Corbie. 

No. 45 ,, Vecquemont. 



XVth 



Illrd 



No. 5 
No. 34 
No. 36 
No. 38 



Corbie. 
Vecquemont. 
Heilly. 
Heilly. 



* On 12th September 1916 the number of medical officers in the Fourth 
Army casualty clearing stations was as follows : — 

Grovetown — 2 /2nd London CCS. . . . . . . . . . . . . 10 

No. 34 CCS 12 

No. 48 CCS. (lightly wounded) 7 

Edgehill— No. 45 CCS 12 

1 /lst South Midland CCS 13 

No. 13 CCS. (lightly wounded) 7 

Heilly— No. 36 CCS 13 

No. 38 CCS 13 

t See British Medical Journal, Vol. II, 1916, pp. 459, 468 and 565. 

10134 E 



38 MEDICAL HISTORY OF THE WAR 

From Xth Corps to No. 3 CCS. Puchevillers. 

No. 44 „ Puchevillers. 

„ Vlllth „ No. 4 „ Beauval. 

No. 29 ,, Gezaincourt. 

Lightly Wounded. 
From XHIth and XVth Corps to CCSs., Heilly. 
Illrd Corps to CCSs., Vecquemont. 
Xth and Vlllth Corps to CCS., Gezaincourt. 

For Urgent Operations {Abdominal Wounds). 
From Vlllth Corps to Advanced Operating Centre, 
Authie. 
,, Illrd and Xth Corps to Advanced Operating 

centre, Warloy. 
„ XHIth and XVth Corps to CCSs., Heilly. 

The casualty clearing stations in each group were filled in 
rotation, as already mentioned. The lightly wounded of the 
Illrd Corps were collected at Contay and Frechencourt and 
sent to Vecquemont in empty trucks on the broad-gauge 
railway. Similarly the lightly wounded from the Xth and 
Vlllth Corps were collected at Acheux and sent to Gezaincourt 
by the narrow-gauge railway. 

Motor Ambulance Convoys. 

The motor ambulance convoys were employed chiefly for 
clearing the seriously wounded. For this purpose a convoy 
was attached to each corps ; No. 10, with the XHIth Corps, 
was parked at the corps main dressing station at Dive's Copse ; 
No. 27, with the XVth Corps, at Heilly ; No. 21, with the Illrd 
Corps, at La Houssoye, on the Amiens-Albert road, but moved 
in September to the corps main dressing station at Lavieville ; 
No. 6, with the Xth Corps, at Toutencourt and afterwards at 
Clairfaye ; and No. 20, with the Vlllth Corps, at Beauval, and 
afterwards at Bouzincourt, near Albert. An additional motor 
ambulance convoy, No. 25, was held under the direct control 
of the D.M.S. of the Army at Les Alencons. 

This was the distribution of motor ambulance convoys in 
the first phase of the battle, but it was found necessary as the 
operations progressed to reinforce both the Fourth and 
Reserve Armies with fresh convoys. Consequently a convoy, 
No. 31, was sent up from the L. of C in the middle of September 
to Les Alencons, and took the place there of No. 25, which 
was moved forward to Corbie in place of No. 10, transferred 



THE SOMME BATTLES OF 1916 39 

to the neighbourhood of Bray and Grovetown, and eventually 
to Becordel-Fricourt at the beginning of October. No. 25 
was also moved to the neighbourhood of Fricourt in November. 

In the northern area No. 26 M.A.C., which had been stationed 
at St. Omer, was transferred to Beauval after the first week 
of July as the reserve convoy under the D.M.S. of the Reserve 
Army. It was moved towards the end of August to the neigh- 
bourhood of Contay, when Contay became a casualty clearing 
station centre. 

Towards the end of September No. 6 M.A.C. was becoming 
unfit for work, and was consequently moved from its front 
area to Beauval, and replaced by a new convoy, No. 30 
M.A.C, which had been brought from the L. of C. 

When the preparations were being made for the attack on 
the Beaumont Hamel position by the Fifth Army, in November, 
No. 31 M.A.C. was transferred from the Fourth Army to 
Couin in the northern sector of the Fifth Army and attached 
to the Xlllth Corps, which was to take chief part in the attack. 

When the operations on the Ancre ceased No. 30 M.A.C. 
was moved back to Doullens. The final distribution of motor 
ambulance convoys to Corps was then adjusted as follows : — 

With the Fourth Army — 
No. 25 M.A.C. attached to the XlVth Corps at Fricourt. 
No. 27 M.A.C. attached to the 1st Anzac Corps at Heilly. 
No 21 M.A.C. attached to the Illrd Corps at Lavieville. 
No. 20 M.A.C. attached to the XVth Corps at Les Alencons. 
No. 10 M.A.C, which had been withdrawn from Fricourt 
on the 19th November, was at Corbie. 

With the Fifth Army — 

No. 26 M.A.C. with the IVth Corps at Bouzencourt. 
No. 30 M.A.C. with the Vth Corps at Doullens. 
No. 31 M.A.C. with the Xlllth Corps at Authie. 
No. 6 M.A.C. at Beauval as Army Reserve convoy. 

Use of Lorries, Buses and Light Railways. 
For the conveyance of the lightly wounded from the lightly 
wounded collecting stations, the lorries of casualty clearing 
stations and such other lorries as could be made available 
were fitted with seats and used for this purpose ; also a number 
of charabancs or buses was placed at the disposal of the 
D.M.S. But the chief method of conveyance of the lightly 
wounded to casualty clearing stations from all except the Xlllth 
and XVth Corps in the earlier phases of the operations was, 

(10134) E* 



40 MEDICAL HISTORY OF THE WAR 

as already noted, by empty supply wagons on the broad-gauge 
railway from Contay to Vecquemont, and by the narrow-gauge 
railway from Acheux to Gezaincourt. On the former the 
empty supply wagons were used, and special arrangements 
were made by the casualty clearing stations at Vecquemont 
for their reception on arrival there, previous to their being 
loaded on to the ambulance trains for conveyance to the base. 
In no case were the empty supply trains used for bringing back 
wounded to the base, and strict orders were issued to prevent 
their being so used without direct instructions from the D.M.S. 
of the Army concerned. 




Wooden trolly line for bringing wounded from the casualty clearing stations 
at Puchevillers to ambulance train siding. Battle of the Somme 1916. 

On the narrow-gauge railway between Acheux and Gezaincourt 
four trains had been organized, each consisting of eight covered 
trucks and three passenger coaches, or nine covered trucks 
and two passenger coaches. Each of these trains was organized 
to carry on an average 60 lying and 20 sitting cases, and it 
was estimated that each train would probably be able to make 
four journeys every twenty-four hours. The running of these 
trains was to be arranged by the railway transport officer at 
Gezaincourt in conjunction with the O.C., No. 29 CCS. The 
entraining arrangements at Acheux were under the control 
of the D.D.M.S., Vlllth Corps, who appointed an entraining 
medical officer. These trains were to be used by both the 
Vlllth and Xth Corps, but the whole of the lying down 



THE SOMME BATTLES OF 1916 



41 



accommodation was reserved for the Vlllth Corps wounded. 
The lightly wounded at the collecting stations at Clairfaye 
and at Acheux were brought back on this line to the casualty 
clearing stations at Gezaincourt, but the trains were also 
available for use at any time to evacuate cases from No. 4 CCS. 
at Beauval to the ambulance trains at Gezaincourt. Acheux 
was frequently shelled by long-range guns, and arrangements 
were made to load the trains at a point west of Acheux instead 
of at the railway station there. 

When the broad-gauge railway had been constructed from 
Dernancourt to Maricourt, it was used for bringing back the 
lightly wounded from the walking wounded collecting station 
near Carnoy to the casualty clearing stations at Grovetown 
and Edgehill. 



Classification of Casualties for Transport. 
A record of the number of stretcher cases, walking cases, 
and shell shock cases was kept by the field ambulances of the 
2nd and 8th Division. The record of the former division 
from 26th July to 11th August is as follows : — 

Table showing the proportion of Lying Cases to Walking 
Wounded Cases in the 2nd Division from 26th July to 
llth August 1916. 





Lying 


Walking 


Shell shock 




cases. 


wounded. 


(wounded). 


26th July 


47 


33 


6 Lying 


5 Walking 


27th 


289 


349 


18 „ 


65 


28th 


329 


110 


44 ,, 


51 




29th 


150 


94 


28 ,, 


54 




30th , 


107 


141 


8 „ 


67 




31st , 


77 


54 


11 


28 




1st August 


84 


50 


10 „ 


16 




2nd „ 


54 


37 


6 ,, 


19 




3rd 




25 


22 


6 „ 


8 




4th 




48 


21 


6 „ 


3 




5th 




22 


12 





6 




6th 




10 


18 


— 


11 




7th 




25 


23 


1 " 


6 




8th 




45 


95 





5 




9th 




17 


36 


1 ','. 


5 




1.0th , 




10 


3 





6 




llth 




5 


2 


1 ',', 


— 


. 


To 


tals 


1,344 


1,100 


146 „ 


355 „ 



Proportion of lying to walking = 1 -22 : 1 -00, or 54-9 per cent, of the 
total cases admitted = lying cases. Shell shock cases had 29-12 per cent, 
of the total as lying cases. 



42 MEDICAL HISTORY OF THE WAR 

The record of the 8th Division is from two field ambulances 
only, No. 24 and No. 25, and for the first three days of the 
battle. The results were as follows : — 

Casualties in the 8th Division — Comparison of Lying and 
Walking Cases. 

1st to 3rd July 1916. 
No. 24 Field Ambulance. 

Total admissions = 1,811 : Total evacuations = 1,757 

Walking cases . . = 285 = 16-2 per cent. 
Stretcher and 

sitting cases . . = 1,472 = 83-8 
No. 25 Field Ambulance. 

Total admissions = 1,245 : Total evacuations = 1,245 

Walking cases . . = 551 = 44-2 per cent. 

Sitting cases . . = 423 = 33-97 

Lying cases .. = 271 =21-7 

Total admissions to the two field ambulances . . = 3,056 

Total evacuations : walking cases . . . . = 836 = 27-9 per cent. 

of total evacuated. 

,, ,, lying and sitting .. . . = 2,166 = 72-1 percent. 

of total evacuated. 

Depots of Medical Stores. 

The medical and surgical supplies of the field units and 
casualty clearing stations of the Fourth Army were replenished 
from No. 14 Advanced Depot of Medical Stores at Corbie, 
No. 18 at Puchevillers, and No. 16 at Beauval ; and in the 
Third Army from No. 13 at Doullens, and No. 15 at Frevent 
at the beginning of the battle. When the Reserve Army 
took over the northern area of the Fourth Army, No. 18 
Advanced Depot of Medical Stores at Puchevillers had to 
supply the units in the northern sector of the latter army, 
but subsequently No. 19 Advanced Depot of Medical Stores 
was brought up from the L. of C. to the Fourth Army area 
on the 7th August, and was opened in Albert. At no time 
did these advanced depots of medical stores fail to meet the 
requirements of the medical units. 

Evacuation from the Casualty Clearing Stations to the Base. 

The success of the arrangements described above depended 
upon the adequacy of the means available for evacuating the 
casualty clearing stations and avoiding congestion of the army 
areas with large numbers of wounded. 

The wounded were evacuated from the casualty clearing 
stations to the base hospitals by ambulance trains, temporary 
ambulance trains, barges on the canal, and by motor ambulance 
convoys on the roads. 



THE SOMME BATTLES OF 1916 43 

The general co-ordination of the work of evacuation was 
directed by the D.D.G.M.S., who was in close touch with 
advanced G.H.Q. at Beauquesne, with the Ds.M.S. of the 
armies engaged, and through the D.G.M.S. office at Hesdin 
with the D.M.S., L. of C. 

Before the battles commenced, the D.M.S. of the Fourth 
Army had estimated the number of wounded that could 
be dealt with in the army area on any one day as 
24,000. His estimate was based on 9,500 being in the casualty 
clearing stations, 10,000 in the various field ambulances, and 
4,900 on ambulance trains at one time In order to maintain 
an evacuation capacity of 4,900 by railway, he required seven 
ambulance trains carrying 400 each and three temporary 
ambulance trains carrying 700 each. This he regarded as the 
minimum number of ambulance trains and temporary ambulance 
trains which should come up to the casualty clearing stations 
daily. The total number of ambulance trains in France at 
the time was 29, of which six were required on the L. of C. for 
moving sick and wounded from hospital centres, such as 
Etaples, Abbeville and Treport, to the ports of embarkation 
for the United Kingdom, so that there were available for army 
areas 23 ambulance trains. An additional train arrived from 
England and was placed on the line on the 10th July. 

Temporary ambulance trains were organized on a new principle. 
They were designated " T.A.T." and numbered consecutively 
from number 100 upwards. They were made up of passenger 
coaches, and were put in commission and given a staff of medical 
officers and orderlies from the time they were required until 
such time as it became no longer necessary to use them. Their 
movements were regulated in the same manner as the permanent 
ambulance trains. Each was calculated to carry 1,000 slight 
cases sitting up. The number in commission during the battles 
was eleven. 

In order to provide seven ambulance trains daily for the 
Fourth Army area, practically the whole of the 23 available 
ambulance trains would have had to run to the Fourth Army 
area. To meet this requirement, therefore, the Ds.M.S. of the 
First and Second Armies were instructed to evacuate their sick 
and the small number of wounded which they were likely to 
have, as far as possible, to the hospitals at St. Omer by road. 
Arrangements were also made for clearing as many as possible 
of the Third Army wounded by road through Hesdin to Etaples, 
and also for retaining sick and wounded in the stationary 
hospitals at Frevent and St. Pol. It was thought that in this 



44 MEDICAL HISTORY OF THE WAR 

way a sufficient number of trains would be available for the 
Fourth Army area, but the number of temporary ambulance 
trains could be increased to any extent required. 

The D.D.G.M.S., however, had grave misgivings with 
regard to the clearing of casualty clearing stations, especially 
in the event of anything occurring to interfere with the running 
of the ambulance trains, and consequently prepared a scheme 
for evacuation by canal and road. In addition to No. 4 
Ambulance Flotilla, which had been organized on the Somme 
when the Fourth Army took over the area from the Third Army, 
he had No. 3 Ambulance Flotilla transferred from the Aire- 
La Bassee Canal to the Somme Canal. As each of these 
flotillas consisted of six barges capable of conveying 30 or 32 
lying down cases each, there was accommodation for 360 serious 
cases in the two flotillas, and arrangements were made to use 
them in clearing the casualty clearing stations at Corbie, Vec- 
quemont and Amiens, to Abbeville. 

The arrangements for evacuation by road were controlled by 
the D.D.G.M.S. from advanced G.H.Q. Arrangements had 
been made in case of necessity for the casualty clearing stations 
in the vicinity of Doullens and in the northern sector of the 
battle area to be evacuated by road to Etaples, through 
No. 47 Casualty Clearing Station at Hesdin. Further arrange- 
ments were made with the D.M.S., L. of C, for 500 sitting 
up cases, capable of enduring a three hours' journey by 
road, being cleared daily to Abbeville from Gezaincourt, 
Doullens, Beauval and Vecquemont on charabancs in case of 
necessity. Charabancs or the motor ambulance convoy at 
Beauval were also to take casualties to Hesdin, where they 
would be first received by No. 47 Casualty Clearing Station 
or No. 20 Field Ambulance, and then transferred, if capable 
of continuing the journey, to Etaples by No. 1 M.A.C., 
then stationed at Hesdin under G.H.Q. control. No. 20 
Field Ambulance, which was permanently stationed as a 
G.H.Q. unit in a chateau near Hesdin, had its accommodation 
expanded in tents for the reception of 500 patients. With 
this and the accommodation in No. 47 C.C.S., 1,000 wounded 
could be accommodated at Hesdin. It was estimated that 
No. 1 M.A.C. could make three return journeys between Hesdin 
and Etaples in the twenty-four hours, the time taken between 
Hesdin and Etaples being two hours. The journey from 
Hesdin to Doullens took over one hour, and the convoy could 
thus make at least two return journeys between Doullens and 
Hesdin, or one return journey between Doullens and Etaples 



THE SOMME BATTLES OF 1916 45 

daily, should it be necessary to send it up to the casualty 
clearing stations in the neighbourhood of Doullens. The 
convoy could also make two return journeys between St. Pol, 
Frevent and Etaples in the twenty-four hours. It was thus 
estimated that No. 1 M.A.C. could clear approximately 1,000 
wounded every twenty-four hours. But in the event of No. 1 
M.A.C. being unable to meet the demand made upon it in 
relieving congestion of casualty clearing stations in the Fourth 
Army No. 26 M.A.C. at St. Omer was held in readiness to be 
diverted to the battle area to assist No. 1 M.A.C, and an 
improvised convoy was prepared at Abbeville for use in case 
of need. Preparations were also made to relieve congestion 
in casualty clearing stations of the armies, which were not 
engaged in the battle of the Somme, by sending up convoys 
from the base in the event of a large number of casualties 
unexpectedly occurring. 

It was fortunate that these arrangements for relieving 
casualty clearing stations by evacuation by road, in anticipa- 
tion of a possible breakdown in the arrangements for evacuation 
by railway, had been made, as a breakdown actually occurred 
during the first twenty-four hours of the battle. 

The Assistant Director of Railway Transport was at Amiens, 
and the D.M.S. of the Fourth Army was in direct communi- 
cation with him with regard to the number of ambulance 
trains or temporary ambulance trains which he required, and 
the place to which they should be sent. The number garaged 
in the army area before the battle commenced was only three, 
and although others could have been brought up rapidly into 
the area on the 1st July had sufficient notice been given, the 
D.M.S. did not inform the A.D.R.T. until the afternoon of 
the 1st July of the additional trains he required, so that the 
full number of trains did not reach the army area until several 
hours later. 

Consequently, by the evening of the 1st July and during 
the night of the 1st /2nd July the congestion in the casualty 
clearing stations was acute, not only because of the failure of 
a sufficient number of ambulance trains to come up into the 
area, but also because the arrangements for clearing wounded 
from the field ambulances to the casualty clearing stations 
acted so well that the wounded came in much more rapidly 
than was anticipated. Further, the favourable weather 
conditions and, to a great extent, the increased capacity 
of the narrow-gauge railway trains between Acheux 



46 MEDICAL HISTORY OF THE WAR 

and Gezaincourt,* added to the rapidity with which the 
casualty clearing stations became filled during the first rush 
of wounded. Unexpectedly large numbers of lightly wounded 
came to Vecquemont, Heilly and Gezaincourt within a. very 
short time of the first attack. Thus, during the first twenty- 
four hours of the battle 863 officers and 22,826 other ranks 
were admitted to field ambulances of the Fourth Army alone, 
and of these, 797 officers and 13,603 other ranks had been 
brought to the casualty clearing stations. In addition, there 
were 304 wounded prisoners of war in the field ambulances, 
of whom 16 had reached the casualty clearing stations, so 
that, out of the total of 23,993 wounded who had been collected 
to the field ambulances during the first twenty-four hours, 
14,416 had been brought to the casualty clearing stations, a 
number greatly in excess of the accommodation available in 
the latter. Five ambulance trains were waiting to be loaded, 
one each at Vecquemont, Puchevillers, and Gezaincourt, and 
two at Heilly. They left during the day with 2,317 wounded, 
so that on the night of the lst/2nd July the number in 
the casualty clearing stations was 12,099, or some 2,500 
in excess of the accommodation in them. It was then that 
road and barge evacuation became imperative ; 2,222 were 
cleared by road within the next twenty-four hours, and 120 
by barges. 

Fourteen ambulance trains and four temporary ambulance 
trains were then brought up, and left the Fourth Army area 
during the 2nd July, clearing a total of 11,299. The temporary 
congestion was thus relieved, and at no subsequent period of 
the operations did a similar occurrence take place, although 
at one time the running of ambulance trains on the Amiens- 
Albert line was interrupted by damage to the lines. 

On the 2nd July, of the 14 ambulance trains, 4 ran to Vecque- 
mont, 6 to Gezaincourt, 2 to Heilly, and 2 to Puchevillers. 
In addition 2 temporary ambulance trains cleared from Heilly 
and 2 from Vecquemont. Two barges cleared from Corbie, 
and 2 from Amiens ; and, by road, No. 1 M.A.C. made one 
journey from Beauval and Gezaincourt to Hesdin, and chara- 
bancs and motor-bus convoys cleared from Corbie, Amiens and 
Vecquemont to Abbeville, and from Gezaincourt to Frevent. 

On the 3rd July, 17 ambulance trains and 6 temporary 
ambulance trains cleared the casualty clearing stations, 

* Instead of the 60 lying and 20 sitting cases for which they were originally 
equipped, they carried 300 sitting cases and a few lying cases each ; and 
four trains ran daily. 



THE SOMME BATTLES OF 1916 47 

3 ambulance trains and 1 temporary ambulance train from 
Heilly, 5 ambulance trains and 1 temporary ambulance train 
from Gezaincourt, 5 ambulance trains and 2 temporary ambu- 
lance trains from Vecquemont, 3 ambulance trains and 2 
temporary ambulance trains from Puchevillers, and 1 ambulance 
train from Douilens. This was the day of maximum evacuation 
from casualty clearing stations during the battle, and, in fact, 
during the whole period of the war. The number evacuated 
from the Fourth Army area by rail on this day was 13,556. 
In addition 1,074 were also evacuated by road from Corbie, 
Vecquemont, Puchevillers, Douilens and Beauval, and 300 
by barges from Amiens, making a total of 14,930. 

The following memorandum was issued by the D.G.M.S. on 
the 10th July with a view to preventing any hitch in the 
running of ambulance trains in preparing for future battles : — 

" During the operations of last week the congestion that was felt in 
casualty clearing stations on the evening of the 1st July and night of 
lst/2nd July was due mainly to the unanticipated rapidity with which 
wounded were collected from the field ambulances to the casualty clearing 
stations and to the fact that the number of ambulance and temporary 
ambulance trains required for clearing the latter did not reach the 
Fourth Army area as early as they were expected. 

" The favourable weather, and to a great extent the increased and 
under-estimated capacity of the light railway trains from Acheux to 
Gezaincourt, added to the rapidity with which casualty clearing stations 
became filled during the first rush of wounded, while the non-arrival of 
ambulance and other trains by the evening of 1st July was due to the 
fact that the A.D.R.T. had not been informed until the afternoon of 
1st July of the actual number of trains required, so that it was impossible 
for the trains to reach the army area until several hours later. 

" To avoid similar congestion of casualty clearing stations in the event 
of operations of equal magnitude taking place, the D.M.S. will invariably 
form an estimate of the number of ambulance trains and temporary 
ambulance trains he is likely to require at a given time and place at least 
twenty-four hours beforehand, and inform A.D.R.T. accordingly. This 
estimate of the number of trains should be based on information received 
from the General Staff and on experience of past operations. With 
these as a guide there should be no great difficulty in calculating the 
approximate number of lightly and severely wounded who are likely to 
arrive at the different casualty clearing stations on any given day, and 
of the number and class of ambulance trains required to meet the con- 
gestion of wounded, which, with the present means of rapid collection 
of wounded from field ambulances, invariably occurs in casualty clearing 
stations on the evening and night following a big battle. 

" Similarly the D.M.S. should inform the A.D.R.T. whenever he 
anticipates that the rush of wounded and the numbers coming into 
casualty clearing stations are diminishing and capable of being dealt 
with by the normal running of ambulance trains, in order that the railway 
authorities may be in a position to release the temporary ambulance 
trains. 

"It is essential that the temporary ambulance trains should not be 
kept in commission longer than is necessary, and the D.M.S. should not 
as a rule ask for them in order to meet a rush of wounded in connexion 
with minor operations or operations in which the number of troops 



48 MEDICAL HISTORY OF THE WAR 

engaged is comparatively small. In such operations evacuation by the 
ordinary ambulance trains, assisted by road evacuation, is generally 
sufficient to meet requirements, and, in any case, Ds.M.S. should realize 
the fact that temporary ambulance trains can always be formed and 
brought up within twenty-four hours, notice being given by them to the 
A.D.R.T. that they are required in a particular area." 

On subsequent days during the whole period of the Battle 
of the Somme the numbers requiring evacuation did not 
approach these figures, and, as already stated, there was never 
any difficulty in dealing with the situation. 

The refusal to permit ambulance trains to run on the newly 
constructed broad-gauge railway from Vecquemont to Contay 
in the earlier phases of the battle was justified by the fact 
that two of the ambulance trains sent up to Contay on this 
line, after it was opened for ambulance trains, went off the 
rails about one mile from Contay, when fully loaded, and it 
was necessary afterwards to run on this line only the earlier 
and lighter ambulance trains, which had been organized from 
rolling stock in France in 1914. 

The running of ambulance trains to the Reserve Army was 
directed by the A.D.R.T. of the Third Army at Doullens, and 
worked smoothly and efficiently. 

Arrangements at the Base. 

The accommodation in the hospitals on the L. of C. and in 
convalescent and stationary hospitals in the front area was, 
on the 1st July, approximately 61,000, including 1,300 for 
Indians, and the number of beds vacant at the time in the base 
hospitals was 30,602, including 428 for Indians, in convalescent 
depots, 5,252, including 465 for Indians ; in stationary hospitals 
in army areas, 383, making a total of 36,237, including 893 
for Indians. Consequently, it became a matter of urgency 
to clear a large number of wounded to the United Kingdom, 
and in doing so a considerable number of slighter cases were 
evacuated from France. As a result of this experience, the 
convalescent depots in France were not only increased in number, 
but were organized for as many as 5,000 convalescents at a 
time, and a large convalescent depot to accommodate that 
number was opened at Cayeux near the mouth of the Somme 
on the 24th July. 

The greatest number embarked on any one day during the 
battle was 11,946, on the 6th July, a figure which also represents 
the maximum number on any one day placed on board ships 
during the war. On the three previous days in July the 
numbers cleared from the base hospitals were 5,609, 8.350 



THE SOMME BATTLES OF 1916 49 

and 7,011. After that date evacuation overseas was carried 
on at the rate of between 4,000 and 5,000 daily until the 
9th July, and between 2,000 and 3,000 daily from then to the 
15th July. The numbers evacuated from the Fourth Army 
area alone during the Battle of the Somme are shown in 
Appendix B, pp. 522-6. 

The ambulance trains from the northern area of the battle 
ran, as a rule, to Boulogne and Etaples, and from the southern 
area to Rouen and Havre, Abbeville and Treport. 



Arrangements for " Shell-shock " Casualties. 

The question of the disposal of shell-shock cases arose during 
the battles. All shell-shock cases were transferred to No. 3 
Canadian Stationary Hospital at the Citadel, Doullens ; and 
from the 12th November, onwards, the diagnosis of shell- 
shock was not permitted to be made in any of the units further 
forward ; cases of that nature were sent back under the 
designation " not yet diagnosed." By the end of the year 
arrangements had also been made for the reception and treat- 
ment of these cases from the First and Second Armies at No. 4 
Stationary Hospital, St. Omer ; from the Third Army area 
at No. 6 Stationary Hospital at Frevent, and from the Fourth 
Army at No. 21 C.C.S. at La Neuville, near Corbie. A specialist 
in nervous disorders was appointed to each of the centres. 
Consulting neurologists were also appointed, Lieut. -Colonel 
Gordon Holmes for the Boulogne, Calais, Etaples bases, and the 
Second and Third Armies ; and Lieut. -Colonel C. S. Myers 
for the Abbeville, Treport, Dieppe, Rouen and Havre bases, 
and for the Fourth and Fifth Armies. 

Sickness during the Battles. 

The health of the troops during the battles was good, but 
a considerable number of cases of diarrhoea and dysentery 
began to appear in August, and went on increasing during 
September and October. The West India Regiment had 
arrived from Egypt, and came into the Reserve Army area in 
September with a considerable number of cases of dysentery 
amongst the men. They appeared to have had an extensive 
outbreak of diarrhoea on the voyage to France, but dysentery 
had already appeared amongst the troops already there. 

Owing to the constant movement of divisions from one area 
to another the divisional sanitary sections were never able to 



50 MEDICAL HISTORY OF THE WAR 

maintain permanent sanitary arrangements in the area through 
which they passed. Consequently, the D.D.G.M.S., after the 
battle and in the absence of the D.G.M.S., brought the matter 
to the notice of the A.G. and suggested that the divisional 
sanitary sections should become extra-divisional troops and 
allotted definite areas of work, thus causing their movements 
with the divisions to cease. This method of enabling the 
divisional sanitary sections to maintain a high standard of 
sanitation in the billeting areas was carried out in the Fifth 
Army area in December, but did not become a generally 
authorized method of utilizing the divisional sanitary sections 
until the following year owing to objections raised by the 
Adjutant-General.* 

Another innovation in the work of the divisions was the 
establishment by a field ambulance of a scabies centre in 
divisional and corps areas for the treatment of men suffering 
from this complaint. 

Casualties. 

The medical services during the Battle of the Somme, con- 
sisting as it did of a continuous succession of major and minor 
operations alternatively during a period of five months, had a 
strain thrown on them which was without parallel. Between 
the 1st July and 30th November 1916, 316,073 wounded were 
admitted to the field ambulances of the Fourth, Fifth (Reserve) 
and Third Armies. In one month, July, the number in all 
of the armies was 145,421, of whom 123,908 were wounded on 
the Somme battlefields. In one period of twenty-four hours, 
from 6 a.m. 1st July to 6 a.m. 2nd July, 26,675 wounded were 
collected by the field ambulances. During July alone, 2,192 
of the enemy wounded were also cared for by the British 
medical services. The strain on individual casualty clearing 
stations was probably even greater than that on the field 
medical units. No. 29 CCS. at Gezaincourt received as many 
as 5,346 in one day alone, during the twenty-four hours 6 a.m. 
2nd July to 6 a.m. 3rd July, and 11,186 in the first three 
twenty-four hour periods of the battle. 

In addition to 289,363 evacuated by ambulance trains 
between July and November 1916 from the Fourth, Fifth 
and Third Armies, 8,739 were evacuated from the Fourth 
Army by barges on the Somme, and 6,183 by road, of whom 
4,198 were carried by motor ambulance convoy and 1,985 

* See General History of the Medical Services, Vol. II, p. 62. 



DAILY ADMISSIONS INTO FIELD AMBULANCES FOR WOUNDS . BATTLE OF THE SOMME, 1916. 



AUGUST 



SEPTEMBER 



OCTOBER 



NOVEMBER 



2 3 4 56789I0III2I3I4I5I6I7I8IS202I2223242S26272629303II 2 3 4 5 6789 10 II 12 13 14 15 16 17 IBI9g0ai£2g3a485|6aaa9303l 123456789 10 II I g 1 3 14 IS 1 6 1 7 1 8 IS ■- 1 . :s30 I 2 3 4 5 6 7 8 9 10 II 12 13 14 15 1617 18 I9202lgag3g4g526gg8g9303l I 3 3 4 5 6 7B9 10 II 1213 14 15 1617 18192021 2223242526 



^5 

=>a 



23.689 



I 9,565 




2 3 4 567 8 9 10H 12 13 14 i5 1617 18 192021 g22^;4 252627 28293031 2 
JULY J 



3 4 5 6 7 8 3 10 li 12 13 14 15 16 17 1313 2021 2gg3g4gS262728 £930 31 I 2 3 
AUGUST ~T 



5 6 7 8 9 1011121314 151617181920212223242526272829301 23466789 10 II 



1314 151617 1819 202122232425262728293031 I 2 3 45 C 7 8 3 1011121314151617181920212223242526 



SEPTEMBER 



OCTOBER 



NOVEMBER 



"qlby & SonsMh 



THE SOMME BATTLES OF 1916 51 

by charabancs or buses. For evacuating these numbers 
ambulance trains made, from the Fourth Army area alone, 491 
journeys, temporary ambulance trains 31 journeys, barges 
290 journeys, motor ambulance convoys 11 journeys, and 
convoys of charabancs or buses 3 journeys.* 

In addition to the wounded, provision had to be made for 
the sick, of whom the average constantly in the care of the 
medical units in the field armies numbered 13,766. 

Casualties were also occurring in armies not actively engaged, 
and the statistics for the whole year 1916 illustrate the extent 
of the work thrown on the medical services in bringing wounded 
and sick back from the army areas to the hospitals on the 
lines of communication. The total number so carried by 
permanent ambulance trains amounted to 713,957, and by 
temporary ambulance trains 23,820, in 1,772 and 29 journeys 
respectively. The numbers carried lying down were 306,690, 
all by permanent ambulance trains, and the numbers carried 
sitting up 431,087, of whom 23,820 were in temporary ambu- 
lance trains. The average number carried on each journey 
of a permanent ambulance train was 330, and of a temporary 
ambulance train 821. The ambulance flotillas brought back 
16,918 during the year, in 565 barge journeys, 7,916 were 
evacuated by the flotillas Nos. 2 and 5 on the St. Omer-Aire- 
La Bassee and Aire-Merville canal, and 9,002 by flotillas 
Nos. 3 and 4 on the Somme Canal. 

Yet, notwithstanding these colossal figures, the medical 
services stood the strain with persistent cheerfulness and 
undiminished vigour. This happy result * could only have 
been achieved by careful preparation of the medical services 
from the front line to the base, and by the loyal co-operation 
of all those over whom the Director-General had administrative 
control. The casualties amongst them were great, 52 officers 
and 406 other ranks were killed, or died of wounds, during the 
battles, and 188 officers and 2,107 other ranks were wounded ; 
while 5 officers and 38 other ranks were reported missing. 
The number of casualties in the R.A.M.C, Canadian, Australian, 
New Zealand and South African Medical Corps, all of which 
at one time, or another were engaged in the front area, is shown 
in the following table. 

* The medical services of the French Sixth Army, which fought on the 
Somme on the right of the British Fourth Army, were reported to have 
evacuated 105,672 wounded and 13,453 sick from their field medical units 
during July to November. They employed six barges on the Somme Canal 
and evacuated by them during July as many as 13,265 patients. 



52 



MEDICAL HISTORY OF THE WAR 



Corps. 


Killed. 


Wounded. 


Missing. 


Officers. 


O.R. 


Officers. 


O.R. 


Officers. 


O.R. 


July. 

R.A.M.C. 
A.A.M.C. 
N.Z.M.C. 
C.A.M.C. 
S.A.M.C. 


15 


129 

4 

1 


58 
2 


744 
39 

35 


2 


13 


Totals 


15 


134 


60 


818 


2 


13 


August. 
R.A.M.C. 
A.A.M.C. 
N.Z.M.C. 
C.A.M.C. 
S.A.M.C. 


7 
1 


46 
10 


29 

2 


183 
43 


— 


4 
2 


Totals 


8 


56 


31 


226 


— 


6 


September. 
R.A.M.C. 
A.A.M.C. 
N.Z.M.C. 
C.A.M.C. 
S.A.M.C. 


12 

1 
1 


102 

3 

12 

22 


55 

1 

5 


488 

9 

77 

100 


2 


4 
15 


Totals 


14 


139 


61 


674 


2 


19 


October. 
R.A.M.C. 
A.A.M.C. 
N.Z.M.C. 
C.A.M.C. 
S.A.M.C. 


6 


32 
6 


20 
7 


164 
38 


1 





Totals 


6 


38 


27 


202 


1 


— 


November. 
R.A.M.C. 
A.A.M.C. 
N.Z.M.C. 
C.A.M.C. 
S.A.M.C. 


8 


31 
6 

2 


7 

1 

1 


143 
33 

11 


— 





Totals 


9 


39 


9 


187 


— 


— 


Grand Totals . . 


52 


406 


188 


2,107 


5 


38 



THE SOMME BATTLES OF 1916 



53 



For all armies the casualties amongst medical officers between 
the 25th June 1916 and the 14th November 1916 were con- 
siderably greater, as shown in the following table : — 





Killed or 
Died of 
Wounds. 


Wounded. 


Missing. 


Totals. 


Field Ambulance M.Os. . . 
Infantry Battalion M.Os. 
Artillery M.Os. 
Administrative Staff 
Casualty Clearing Station M.Os. 
Sanitary Officers 


20 

43 

9 

1 

1 


65 

149 

18 

2 

6 


4 


85 
196 

27 
3 
6 
2 


Totals 


74 


241 


4 


319 



CHAPTER III. 

THE ADVANCE TO THE HINDENBURG LINE IN 1917. 

THE winter of 1916-17, following the battles of the Somme 
and Ancre, was one of great severity, with continuous 
frost and much snow. When the thaw came many of the 
roads were badly damaged, and this interfered considerably 
with the smooth running of motor ambulance transport, es- 
pecially along collateral routes of evacuation. Repairs were, 
however, actively undertaken, and by the time the spring 
offensive of 1917 commenced roads were in fair condition along 
the main lines of evacuation, although the collateral routes 
were still in a very bad state. 

The British line had been extended south of the Somme 
during February as far as the Amiens-Roye road to a point 
about four miles north-west of Roye ; the whole British front 
was then 110 miles in length, occupied by the Fourth Army 
on the right from the Roye road to opposite Le Transloy, 
by the Fifth Army to opposite Serre, by the Third Army to 
Arras, by the First Army to Armentieres, and by the Second 
Army on the extreme left to Ypres. At that time preparations 
were being made for a general offensive with a view to cutting 
off the enemy salient between Arras and Le Transloy ; but, 
before the winter had set in and during January, February 
and March 1917, the Fifth Army continued its pressure in the 
Ancre region and advanced its line to Grandcourt, Miraumont, 
Serre, Gommecourt and Irles, so that the salient in this area 
had been reduced to a continuous front facing Bapaume. 
The enemy then withdrew to his new defensive system, the 
Hindenburg line, which ran roughly from Tilloy-les-Mafflaines, 
immediately south-east of Arras, through Neuville Vitasse, 
Bullecourt, Quean t and Havrincourt to St. Quentin. His 
retreat was closely followed up by Fourth and Fifth Army 
troops and the right sector of the Third Army from the 17th 
March onwards, so that by the beginning of April these armies 
were established on a line facing the enemy's defences from 
Arras in the north to St. Quentin in the south. Both during 
and after the battles, which commenced on the 9th April 
on the Arras and Vimy Ridge front, continuous pressure was 
maintained against this line, occasionally with fiercely fought 



ADVANCE TO HINDENBURG LINE IN 1917 55 

local attacks, especially at Bullecourt, until the more extensive 
operations of the summer and autumn of 1917 led to a complete 
readjustment of the British front and a rearrangement of the 
army areas. 

Medical Preparations for the Advance. 

The medical arrangements for the advance to the Hindenburg 
line and for the subsequent battles of Arras and Vimy Ridge were 
made by the Ds.M.S. of the armies engaged, and the D.G.M.S. 
at G.H.Q. was scarcely called upon to make any special pre- 
parations for them beyond co-ordinating the work and building 
up a strategical situation adapted for the proposed spring 
offensive. The chief anxiety felt by the D.G.M.S. was with 
regard to the number of hospital beds vacant on the lines of 
communication. 

On his behalf the D. D.G.M.S. held a conference at Hesdin 
of Ds.M.S. of Armies and of the L. of C. on the 2nd April, when 
the general strategical position of the medical services with 
regard to the coming offensive, and the policy which it was 
desirable that the Ds.M.S. should follow, were explained. 
Broadly, the policy was for the Second and Fourth Armies, 
which would not be actively engaged, either to retain as many 
of their sick and wounded as possible in the army area, in order 
to avoid the necessity of sending ambulance trains to them 
until the pressure had decreased, or to relieve congestion in 
their units by road evacuation to hospitals in St. Omer and 
Abbeville. The Fifth and Second Armies were also to be 
prepared, if necessary, to receive wounded by lateral routes 
of evacuation from the Third Army and the First Army 
respectively. The Directorate of Transportation had arranged 
to repair certain roads for these lateral means of evacuation. 

Anxiety regarding Hospital Accommodation. — During the five 
months of the Somme battles the number of sick and wounded 
that were evacuated from France averaged over 70,000 monthly, 
but after that period there was a tendency to retain sick and 
wounded in France instead of evacuating them to England. 
Thus, during December 1916 and January and February 1917 
the numbers sent out of France were less than 40,000 in each 
of these months. Consequently the number of permanently 
equipped beds which remained vacant gradually became less 
and less until, on the eve of the offensive against the Arras- 
Le Transloy salient, with an anticipated casualty list of some 
30,000 during the first twenty-four hours, the number of these 
vacant beds in hospitals on the L. of C. was little more than 

10134 F 



56 MEDICAL HISTORY OF THE WAR 

7,000 on the 22nd February 1917, with about the same number 
in convalescent depots, and some 2,000 in stationary hospitals 
in army areas. The situation was so critical that the D.D.G.M.S. 
was sent to the War Office, where he had a conference on the 
subject with the A.G., the D.G.A.M.S., and others on the 
24th February. Two alternatives were then suggested, one 
was to increase the evacuation from France to 4,000 daily for 
a week or ten days in order to have a margin of 30,000 to 
40,000 vacant beds, or to add 20,000 beds to the hospital 
accommodation in France by expansion and mobilize more 
general and stationary hospitals. For this purpose it was 
suggested that five general and nine stationary hospitals 
should be sent to France. Ordnance equipment for this 
expansion of beds was available, but the chief difficulty was 
lack of medical personnel. The D.G.M.S. in France was 
prepared, however, to accept for general and other hospitals a 
reduced establishment of one medical officer for every 100 beds. 
But the only immediate measure possible for relieving the 
congestion of the base hospitals in France was increased 
evacuation to England, and the A.G. agreed to the numbers 
evacuated daily being doubled until a sufficient number of 
vacant beds was obtained. This was carried out immediately 
after the D.D.G.'s visit, and the vacant beds gradually increased 
until, on the 13th March, the number exceeded 30,000, and 
remained above that figure until the beginning of April, when 
the vacant beds were again rapidly filled by the unloading of 
sick who had been retained in army areas in anticipation of 
the approaching battles. 

Reconnaissance for New Hospital Centres. — In order to avoid 
similar conditions in future, the A.G. at the War Office asked 
that a reconnaissance should be made of the areas south of 
the Seine with a view to the selection of additional sites for 
hospital centres and convalescent depots. Sites in Brittany 
had been suggested, but hospital centres far from the front 
line had many disadvantages, and, although reconnaissances 
were made in the vicinity of Brest, Cherbourg and elsewhere, 
the proposal to send the sick and wounded to Brittany was 
abandoned. Subsequently a site near Deauville-Trouville was 
selected. It was not ready, however, to receive convalescents 
or others until the following August. The proposal to send 
over five general and nine stationary hospitals resolved itself 
into seven new general hospitals of 1,040 beds each being 
organized from existing Territorial Force general hospitals. 
They arrived in France in April 1917. 





SCRV T 


Frr-*FS- 


fiSVH. 


WAft-gM U-r. — TO 


' r^f 


IA^iL 


7a-r." -r 


sT-^wr-Tf 


[raTMllTTM'UNM 
30OOO | 






-LUiU. 


\a 






^ 








550OO 


CHART SHOV 


MNG V/ 


kQANT 




\\ 








5477 
O/ 1 


4-&S 




3fOOO 


&E.DS 


IN L'OI 


••C.HO 


JPlTAli 




\ 


^A 






V/A4Y 


5 /4427 




J30OO 


a,NDCoMXW.E5 


:ent D 


£ POTi? 








_J 




COMA* 






32COO 


N Rv 


^NCE. 


DURIH 


| THE 






"t 


xA 










s/ooa 


PRfcF*J 


^T»ON 


5 FOR 


THE 








N 












SOOOO 

\ 


5PRlh 


G O^ 


FENSI> 


rE ?H 




















29000 J 


=J2! 


Z" 






















eaooo 




























Z7000 i 


























zsooo 


























ZSOOO 


























Z9CO0 




























SSOOO 




























ZSIOOO 




























Z/OOO 




























SOOOO 
















1 










13000 
















1 










teooo 












— 


— 




^ *- 








/7000 














\A 








■•6000 






















\ | 


<W- 


tsooo 






















r 


r 


weoo 
























/ 


/3000 J 














.L _ 


i 




1 


*^ 


/£OOOJ 


















\ 








'/OCtcT 


















\ 
















■ p- 


A v „ 




1 




•* 














: V 


1 


S* 


b^ 


v 






3000 


\ 




, ? 










v 


U' 






7000 




., / '™ 












.. 


* 

\ 








GOOO 
















\ 




/•'%A 




sooo 


















r*\ 


> 


4000 


















i/ 






$000 






1 
















aooo 


The continuous une represents the number of equipped 
beds vacant in hospitals on "the l-ines op co*\municat 


I OK. 




/ooo 


the dotted une re.pre5ents vacant accommodation 
^ in Convalescent Oepots. -^ 





/3.2848C 5060'i4i I500.II.ZZ. 



S Ci 



ADVANCE TO HINDENBURG LINE IN 1917 57 

Estimate of Ambulance Train Requirements. — The number of 
ambulance trains which were likely to be required for the 
offensive had been considered by the D.D.G.M.S. in consulta- 
tion with the Directorate of Transportation. At the beginning 
of 1917 the following daily journeys of permanent ambulance 
trains were estimated as likely to be necessary in preparing 
for the offensive : — 



First 24 hours 


18 ambulance 


trains for 8,000 


Second ,, 


,, 


i > > > 


Third 


,. 


,, 


Fourth 


,, 


> > > > 


Fifth 


11 


5,000. 


Sixth 


9 


4,000. 


Seventh 


7 


3,000. 



These were calculated on the assumption that during the 
first three periods of twenty-four hours between 40 and 50 
per cent, of the wounded could be dealt with by temporary 
ambulance trains supplemented by road evacuation to the 
base, or by road evacuation to casualty clearing stations of 
armies not actively engaged. But after the first three days 
it was calculated that the wounded left in the casualty clearing 
stations would be of a more severe type, and that, therefore, 
a larger proportion would require evacuation by permanent 
ambulance trains than by temporary trains. The number of 
temporary ambulance trains, therefore, required during the 
first three periods of twenty-four hours was estimated at 
nine daily, for the fourth period four, and for the fifth and 
sixth periods one each. 

The requirements as estimated by the D.D.G.M.S. were, 
consequently, for 54 journeys by permanent ambulance trains 
and 27 journeys by temporary ambulance trains during the 
first three days for the purpose of evacuating 48,924 wounded. 
This was the estimate of probable requirements before the 
Germans had withdrawn from the Arras-Le Transloy salient, 
and was therefore considerably in excess of what was eventually 
necessary. It was, however, believed at the time that the 
casualties requiring evacuation from casualty clearing stations 
would be considerably greater than during the earlier days of 
the Somme battle, during the first three days of which 35,814 
were evacuated from the Third and Fourth Armies. 

Arrangements for Lightly Wounded and Sick. — Some anxiety 
was felt with regard to the running of the ambulance trains. 
The main line railway ran south from Lapugnoy to St. Pol, 
Frevent, Doullens and Gezaincourt to Abbeville, and was 
joined by branch railway lines running from casualty clearing 

(10134) F* 



58 MEDICAL HISTORY OF THE WAR 

station centres at Warlincourt, Agnez les Duisans, Aubigny, 
Bruay, Barlin, Coupigny, Bethune, and Noeux-les-Mines. In 
consequence of the military necessity of restricting the number 
of ambulance trains running on the branch lines to these 
casualty clearing station centres, it was essential that as many 
as possible of the sick and wounded should be brought by road 
to medical units on the main line. The medical units at St. 
Pol, Frevent, Doullens and Gezaincourt were consequently 
kept chiefly for the sick and wounded who could be transferred 
to them in lorries or buses. No. 29 CCS. at Gezaincourt 
was in the Fifth Army area, and although before the battles 
the D.M.S. of the Fifth Army wanted to close Gezaincourt 




Regimental aid post in Hindenburg Trench. 

and Varennes and transfer the casualty clearing stations 
there to a more forward area, the policy of G.H.O. made it 
necessary to retain them, in case they might be required for 
the reception of sick and wounded brought to the main line of 
railway at Gezaincourt or from the Third Army by the lateral 
routes leading to Varennes and thence to Gezaincourt. 

The Medical Services during the Advance. 

During the advance to the Hindenburg line the work of the 
medical services presented few features that were new. Unlike 
the only previous operations with which they were comparable, 
namely ; the advance to the Aisne in September 1914, the 
arrangements for the collection and evacuation of casualties 
followed a methodical and organized system, under army, 



ADVANCE TO HINDENBURG LINE IN 1917 59 

corps and divisional administrative medical control. Regi- 
mental aid posts, advanced and main dressing stations, and 
walking wounded collecting posts were established in echelons 
conforming with each forward movement. The work of the 
bearer divisions, however, was much hampered during these 
operations by the condition of the ground and roads over 
which the advance had been made. The roads were broken 
by shell-holes and mines, and the ground off the roads was deep 
in mud. The bearers worked from the regimental aid posts 
over this broken country by a system of relay posts. 

The Ilnd Corps 'Medical Services. — The advance on both 
flanks of the Ancre Valley was made by divisions of the Ilnd 
Corps, and south of the Albert-Bapaume road by divisions of 
the 1st Anzac Corps. The Ilnd Corps divisions were the 2nd 
on the right, the 18th in the centre, and the 63rd (R.N.) on 
the left. The work of the front line medical services and 
the physical conditions with which they had to contend 
during the advance are well described in the following account 
by the A.D.M.S. of the 18th Division (Colonel J. Poe) and 
by the accompanying map. 

" On 1st January 1917 the 18th Division were in rest with the Ilnd 
Corps near Abbeville. 

On 11th January they marched forward, and on the 16th took over 
from the 61st Division the portion of the line south of the Ancre that 
they had previously held in December. 

The division was warned that the Ilnd Corps (63rd, 18th and 2nd 
Divisions) were to attack in about a month's time. 

The 63rd Division were astride the River Ancre, the 18th Division held 
the line from about 700 yards south of Grandcourt to some 1,000 yards 
south of Petit Miraumont, and the 2nd Division were to the east of the 
latter point. 

The chief problem of all services was the extraordinary difficulty of 
transport. 

East of the Ancre there were four possible lines of evacuation : — 

1. The river road, Hamel-St. Pierre Divion. 

2. Nab Valley road, running from Aveluy to near Moquet Farm. 

3. Centre road running to Aveluy-Ovillers — R.33.d. Central. 

4. The Albert-Bapaume road. 

There was also a cross-road connecting Nab Valley road with Pozieres, 
but in bad weather this was impassable for wheeled traffic at the head of 
Nab Valley, and was very bad but just passable near Pozieres Cemetery. 

The other roads were all in a very bad condition, but were passable for 
motor ambulances. 

All the country in front of the line held on 1st July 1916 was impassable 
even for pack animals except on made roads, and the only way of con- 
veying wounded north-east of the line St. Pierre Divion-Pozieres was 
either by stretchers along duckboards, or by a single line of light railway 
track, along which trucks were pushed by hand. 

The accommodation east of the Ancre consisted of an advanced dressing 
station at Aveluy Post, and, east of that, of two or three German dugouts. 

The Ilnd Corps selected Aveluy Post as their main dressing station. 



60 MEDICAL HISTORY OF THE WAR 

The 18th Division chose the Quarry crossing north-west of Pozieres as 
the site for their advanced dressing station. 

About 18th January, five weeks of hard frost commenced, and the 
whole of the wet mud froze to the hardness of a metalled road ; this made 
transport much easier, but made it excessively difficult to do any digging, 
and excavations for dugouts could only be made with the assistance of 
explosives. 

The following accommodation was made : — 

At the advanced dressing station, Quarry Crossing — four elephant 

hutches. 
Rifle Dump between Pozieres and Courcelette — two elephant 

hutches. 
Hessian Trench, near tramhead, Valley of Death — one tunnelled 

dugout (bearer relay post). 
Regina Trench, slightly north of Hessian Trench — one tunnelled 
dugout. 
The site for the advanced dressing station was chosen because it was 
the point at which the tramway cut the furthest forward road. The 
site was shelled occasionally, and therefore dugouts were necessary. 
These were made with steel shelters (elephant hutches). Other similar 
shelters were installed in a small depression at the Rifle Dump. 

In front of this the whole country was in full view of the enemy and 
only tunnelled dugouts were safe. It was, however, very difficult to 
treat stretcher cases in tunnelled dugouts, and, moreover, the surrounding 
sea of mud made any surgical treatment especially difficult. 

The system adopted was to obtain tunnelled dugouts as shelter for 
bearers and instruct all ranks that the all-important point was to get 
all wounded back as rapidly as possible, the first place where full dressings 
could be done being at the advanced dressing station at Quarry Crossing. 
The evacuation of wounded was entirely dependent upon the tramline, 
which the R.A.M.C. assisted to build ; this ran from Aveluy Post through 
Ovillers, Quarry Crossing, Rifle Dump to tramhead at Hessian Trench. 

On 3rd February the 63rd Division advanced north of the Ancre and 
the enemy evacuated Grandcourt on 6th February. 

On 7th February the 18th Division took Folly Trench, east of Grand- 
court, with light casualties. 

On 9th February the 18th Division took over the line up to the south 
bank of the Ancre. 

On 15th February the thaw commenced and the whole country-side 
turned into a sea of mud ; motor ambulances could still proceed along the 
metalled roads shown in the map, but these became very difficult. The 
important lateral communication Thiepval-Pozieres road became 
impassable for wheeled traffic near Moquet Farm and almost impassable 
for motor ambulances at Pozieres. The Ovillers road remained passable, 
but only east-bound traffic was allowed along it ; the advanced dressing 
station was therefore in great danger of being cut off from all connexion 
with the rest of the world. 

On 17th February the 18th Division took Boom Ravine; about 500 
walking wounded and 180 stretcher cases were evacuated between 
8 a.m. and 8 p.m. The stretcher cases were carried to tramhead at 
Hessian Trench, a distance of 2,400 yards ; they were then pushed along 
the tramline for 2,300 yards to the advanced dressing station. Thence 
a number were conveyed by petrol trains direct to Aveluy Post ; others 
were carried 600 yards down the road to the head of Nab road and 
thence cleared by motor ambulances. 

The regimental medical officers had aid posts in Boom Ravine, and the 
bearer officers did dressings in a German gun-pit a little to the south-east. 
Four relays of bearers were required to carry from Boom Ravine to the 
tramhead north of Rifle Dump. This carry was uphill all the way, 
over ground completely destroved by shell-fire and knee deep in mud, 



I 



ADVANCE TO HINDENBURG LINE IN 1917 61 

and the whole course was shelled heavily all day. It was the heaviest 
work our bearers ever had to perform. ; all the bearers of the three field 
ambulances were employed. All the wounded were cleared by 6 p.m. 

After this attack there was a lull for eight days, during which time 
efforts were made to repair the damage done by the thaw to the roads 
and tramlines. 

On 25th February it was reported that the enemy had evacuated 
Miraumont, and on the 26th the 18th Division had occupied Miraumont 
and Pys and were holding the line in front of Irles. 

Evacuation of wounded now became very difficult, as there was no 
road east of the line St. Pierre Divion-Pozieres passable for wheeled 
traffic except the Albert-Bapaume road, which lay too far south to be 
of any use. 

The following line of evacuation was formed : — 

Regimental aid post and advanced bearer relay at Red Cross Gulley, 

2,000 yards from front line. 
2nd bearer relay south-east of Petit Miraumont. 
3rd relay at head of Boom Ravine. 
4th relay at Oxford Circus. 
5th relay at Valley of Death. 
6th relay at Tramhead. 
7th relay at Rifle Dump. 

8th relay at Quarry Crossing advanced dressing station. 
This line involved a stretcher carry of 5,000 yards, followed by a tram 
journey of 2,400 yards. 

The tramline could only be worked by pushing by hand. It effected 
a great saving of personnel, as four men could push four patients, never- 
theless the work involved was as hard as carrying a stretcher. 

As the advanced dressing station at Quarry Crossing was now safe 
from shell-fire, the accommodation there was increased by levelling the 
ground and erecting tents, sufficient to form a divisional main dressing 
station, but, unfortunately, the roads leading to it went steadily from 
bad to worse. 

During the first week in March great efforts were made by the division 
to push the tramway forward and repair the river road through Grand- 
court. 

On the 10th March the division took Irles, and on 13th March the 
enemy retired to Achiet le Grand. 

The roads through Miraumont and Irles were found to be practicable 
for wheeled stretchers, and cases were taken to Miraumont by wheeled 
stretchers and thence carried by hand to the new tramhead south of 
Petit Miraumont, and thence pushed by hand 5,500 yards to Quarry 
Crossing. Fortunately the casualties were very light. 

On the 17th March the enemy evacuated the Achiet le Grand* line 
and retired to Croisilles. 

On the 18th the division occupied St. Leger. An advanced dressing 
station was formed at Bihucourt in a factory the enemy had not destroyed. 
Empty horse ambulances were got forward through Grandcourt and 
Miraumont and worked between St. Leger and Bihucourt ; another relay 
of horse ambulances worked from Bihucourt to Miraumont, thence cases 
were evacuated along the tramlines as the Grandcourt road was too bad 
to send loaded horse ambulances along. 

On the 19th one Ford car was got forward through Bapaume to 
Bihucourt and worked between St. Leger and Bihucourt. 

The work of evacuation was assisted by the light horse ambulances 
of a cavalry division which came forward with the 18th Division. 
The line of evacuation was therefore as follows : — 

St. Leger — Bihucourt — Petit Miraumont : 13 miles by horse 

ambulances. 
Petit Miraumont — main dressing station at Quarry Crossing : 
three and a quarter miles by push tramline. 



62 



MEDICAL HISTORY OF THE WAR 



On the 20th the 18th Division attacked Croisilles, and had 50 casualties. 
On the night of the 20th the 18th Division were withdrawn to rest. 

The history of the medical arrangements of the 18th Division during 
these three months is simply the story of a struggle against difficulties 
of transport. Evacuation of wounded would have been impossible 
without the use of tramways, unfortunately the petrol tractors were 
only of a limited use, as the forward lines had to be laid so hurriedly as 
to be unfit to carry the tractors. 



714E Advance to the Hindenburg Line. 

TT Corps Front. 




MOTOJZ. AMBS. 



The line Aveluy Post-Quarry Crossing was used on 17th February 
with great success, but the same day its use was forbidden for wounded 
by the Ilnd Corps on the ground that this use delayed the bringing up 
of ammunition. 

The evacuation of wounded was very seriously handicapped throughout 
the period under consideration by the appalling state of the few existing 
roads behind our lines, the roads between the River Ancre and the 
Thiepval-Pozieres line often became impassable in places even for 
horse ambulances, and west of the River Ancre, between Aveluy and the 
casualty clearing stations at Varennes or Contay, the roads were also 



ADVANCE TO HINDENBURG LINE IN 1917 63 

in a very bad condition, and the journey of ten to twelve miles back 
to the casualty clearing stations was very bad for the seriously wounded. 
This journey was greatly shortened when casualty clearing stations at 
Edgehill came into the Fifth Army area about the 10th February. 

During the advance from Miraumont-St. Leger the value of horse 
ambulances was brought out in a most striking manner. Without them 
it would have been impossible to have evacuated the wounded from 
St. Leger." 

The Medical Services of the 1st Anzac Corps. — In the advance 
to Bapaume between the 14th March and 5th April the medical 
services of the 1st Anzac Corps were chiefly involved. The 
tramline ran to the advanced dressing stations at Le Sars, 
on the Albert-Bapaume road, and at Factory Corner between 
it and Guedecourt over an area pitted with shell-holes, and the 
work of carrying the casualties back to them was similar to 
that described above. The Factory Corner line was extended 
on the 18th March to Warlincourt, and casualties could then 
be brought back by it to the main dressing station at Bazentin- 
le-Petit. The petrol tractor trains were a great help, as 
casualties could be brought to the dressing station in half an 
hour instead of three and a quarter hours, which would have 
been the time required had the whole carrying to be done 
by hand. 

Motor ambulance convoys were able, as a rule, to come up 
to the main dressing station positions, but the journey back 
to the casualty clearing stations was considerably longer than 
during the Somme operations. The chief difficulty was the 
broken state of the roads after the thaw. 

The Casualty Clearing Stations. — The casualty clearing 
stations remained grouped in the positions to which they had 
been moved in the later phases of the Somme battles, while 
the main dressing stations advanced. Consequently when the 
advance to the Hindenburg line had been made, the chief work 
of the medical services in the armies concerned consisted in 
selecting new sites for groups of casualty clearing stations in 
more advanced positions in the area taken from the enemy, 
and establishing them there. 

The Fourth Army, which had taken over the area north and 
south of the Somme from the French, took over the huts 
of several excellently organized French field ambulances and 
clearing hospitals, notably near Bray, Gailly and Cayeux, 
and also brought casualty clearing stations forward to Peronne- 
la-Chapelette, Nesle, Tincourt and Ytres, closing its former 
casualty clearing station centres at Allonville, Corbie, Heilly 
and Grovetown. Edgehill, its remaining centre, had come 



64 MEDICAL HISTORY OF THE WAR 

into the Fifth Army area in February on the Fourth Army 
extending its front south of the Somme. Tincourt and Ytres 
then became the chief casualty clearing station centres of the 
Fourth Army, the former being close to the main Peronne- 
Gambrai railway line and the latter near a new broad-gauge 
railway. Ambulance train sidings were constructed at each 
of these centres. Two casualty clearing stations (Nos. 48 and 
21) were established at Ytres, and four (Nos. 39, 36, 5 and 13) 
at Tincourt, No. 39 and No. 13 having been transferred from 
Gailly and replaced there by a stationary hospital (No. 41) 
from the lines of communication. 

The new sites for groups of casualty clearing stations in 
the Fifth Army area were at Achiet-le-Grand and Grevillers. 
The sites at Puchevillers and Contay were then given up, as 
also Recmenil Farm and Gezaincourt, but the last of these 
sites, with No. 29 G.C.S., was retained, as already noted, by 
instructions from G.H.Q., until May, when the Arras battles 
were coming to an end. Two casualty clearing stations were 
established at Achiet-le-Grand, near the main line of railway 
from Albert to Arras, and three at Grevillers, in open fields 
on either side of a new broad-gauge railway. The group of 
casualty clearing stations at Varennes was retained, but with 
two in place of three, and a single casualty clearing station was 
kept at Edgehill. Single units were also placed at Aveluy 
and Colincamps. 

The medical services of the Fourth and Fifth Armies 
during the ensuing battles of Arras were thus chiefly engaged 
in establishing these new posts and organizing advanced 
and main dressing stations, divisional and corps rest stations, 
and special centres for the treatment of scabies, nervous 
disorders, and dentistry in their new areas. The special 
preparations for the battles of Arras and Vimy Ridge were 
confined to the Third and First Armies. 









CHAPTER IV. 

THE BATTLE OF ARRAS, 1917. 

AS mentioned in the previous chapter the Third Army had 
been making preparations for an offensive directed south- 
wards against the right flank of the enemy's salient between 
Arras and Le Transloy, but, on the Germans withdrawing to 
the Hindenburg line, these were converted into preparations for 
a combined offensive of the Third and First Armies against 
the positions between Arras and Lens. For these operations 
the Third Army had taken over from the First Army the 
XVIIth Corps, which was occupying the sector between Arras 
and the Vimy Ridge, and with it, in January, also the casualty 
clearing stations (No. 30 and No. 42) in Aubigny. The Vllth 
Corps was in the sector south of Arras, and the Vlth Corps in 
the Arras sector ; with the XVIIIth and XlXth Corps in back 
areas for divisions in reserve or brought back for rest. 

The 1st, 2nd and 3rd Cavalry Divisions of the Cavalry Corps, 
with the headquarters of the corps, also moved into the Third 
Army area behind Arras, ready to exploit any successes of the 
divisions attacking the German line ; the 2nd Cavalry Division 
behind the Vllth Corps, the 3rd Cavalry Division behind the 
Vlth Corps, and the 1st Cavalry Division behind the XVIIth 
Corps. 

Medical Preparations for the\Battle. 

The Casualty Clearing Stations. — The D.M.S. of the Third 
Army (Surg.-General J. M. Irwin) had three main groups of 
casualty clearing stations, three at Warlincourt Halte (Nos. 20, 
43 and 32) in the Vllth Corps area, three at Agnez-les-Duisans 
(Nos. 19, 41 and 8) in the Vlth Corps area, and four at Aubigny 
in the XVIIth Corps area, No. 1 Canadian from the Second 
Army and No. 24 from Egypt having been added in March to 
the two already there. 

The Warlincourt Halte group was seventeen or eighteen miles 
distant from the front line of the Vllth Corps, and sites in a 
more forward position were considered, but until the enemy 
withdrew to the Hindenburg line sites further forward in this 
corps area were too dangerous, owing to their being exposed to 
hostile fire from the salient south of the Arras-Doullens road ; 
while after the Hindenburg line had been reached it was too 
late to organize for the Arras battle a new group of casualty 

10134 G 



66 MEDICAL HISTORY OF THE WAR 

clearing stations in a more forward position. Casualty clearing 
stations consequently remained at Warlincourt Halte until 
after the battle, but an advanced operating centre for abdominal 
wounds and for urgent operations was opened at a main 
dressing station at Ficheux during April, some 11,000 yards 
behind the front line. 

After the fighting in the Arras area had died down and the 
new line held by the British was advanced to between five and 
six miles east of Arras, the casualty clearing stations at Warlin- 
court were moved forward to the neighbourhood of Boisleux- 
au-Mont, between the Arras-Boiry Ste. Ric trade road and 
the railway line. 

A broad-gauge railway was under construction from Warlin- 
court Halte to join the Arras-St. Pol line near Duisans by way 
of Wanquetin ; and Wanquetin was originally regarded as a 
suitable advanced site for the group of casualty clearing stations 
in the Vlth Corps area ; No. 41 CCS. had been moved to it 
from Doullens at the end of 1916 before the railway had been 
completed. For military reasons, however, the site had to be 
abandoned as a casualty clearing station centre towards the 
end of February. A new site had been selected near the same 
railway line at Agnez-les-Duisans, where a group of three 
casualty clearing stations (No. 19 from Doullens, No. 41 from 
Wanquetin, and No. 8 from Bailleul in the Second Army area) 
was established by the beginning of March. An ambulance 
train siding was constructed to it from the new line of railway. 
The site was just south of the Arras-St. Pol road and not more 
than 11,000 yards from the Vlth Corps front line. It was 
consequently within the danger zone of hostile artillery, and in 
fact enemy shells passed over it to the fields beyond, as well as 
doing damage in the village of Duisans, to the east of the site. 
The casualty clearing stations, however, remained untouched, 
and owing to their convenient proximity to Arras were not 
abandoned. They were allotted for the reception of wounded 
from the Vlth Corps and for wounded in need of urgent 
operation from medical units of the XVI I th Corps. 

The group at Aubigny was allotted for the reception of 
XVIIth Corps wounded. The two origpijally there were close 
to the railway station on the south of the line, one of them on 
the site and in the huts of a French clearing hospital ; but No. 1 
Canadian and No. 24 Casualty Clearing Stations were opened 
under canvas in fields, with a bad approach road, on the north 
of the line. These latter were allotted subsequently for the 
reception of wounded from the First Army, but they remained 



MEDICAL SITUATION OF THE 
BATTLES OF ARRAS & VIMY RIDGE 
APRIL 1917 . 



Casualty Cleaning Station 




1218. 2*34° 506C l4'.lS00-8'23 



MalbyASonsLith. 



THE BATTLE OF ARRAS, 1917 67 

for purposes of evacuation under the administrative control of 
the D.M.S, of the Third Army. 

In addition to these groups for the three corps in the line, 
there was one casualty clearing station, No. 37, at Avesnes-le- 
Comte, another at Doullens, No. 62, and a third, No. 63, which 
had recently arrived from England, at Boubers-sur-Canche, in 
factory buildings on the Canche river, some three miles west 
of Frevent. These were used for the reception of sick from 
divisions in the line and back areas, and for slighter cases of 
wounds. There were also two stationary hospitals, No. 12 at 
St. Pol, and No. 6 at Frevent, to which wounded able to sit up 
were to be taken by road or by the narrow-gauge railway which 
ran from Warlus, through Avesnes-le-Comte, to Frevent. 

On the 5th April each of the casualty clearing stations in the 
Warlincourt, Agnez-les-Duisans and Aubigny groups were 
reinforced by surgical teams, six teams being sent from casualty 
clearing stations in the Fifth Army, and four from the casualty 
clearing stations in the Second Army by order of the D.G.M.S. 
In addition the D.M.S.,L. ofC, was ordered on the 5th April to 
send a medical officer to each of these casualty clearing stations 
from base hospitals, and on the 12th April ten more medical 
officers were ordered to the Third Army casualty clearing 
stations from the Second Army. Fourteen nursing sisters, in 
addition to those who came with the surgical teams, were sent 
to the Third Army by the Matron-in-Chief , and ten more were 
subsequently sent to Aubigny on the 11th April. The hospitals 
at the base, however, were not called upon to supply surgical 
teams ; but forty emergency stretcher bearers were sent for 
duty at the casualty clearing stations from the L. of C. before 
the battle and further reinforcements during the battle. 

When the advanced operating centre was opened in the 
Vllth Corps area surgical teams and nursing sisters were sent to 
it ; and also to an advanced operating centre which was opened 
on the 17th April in the Hopital St. Jean in Arras by a field 
ambulance of one of the Vlth Corps divisions. 

In addition to these reinforcements from outside the Third 
Army, the D.M.S. of the army issued instructions for corps to 
send to each of the casualty clearing stations allotted for the 
reception of their wounded 3 officers, 3 N.C.Os. and 24 other 
ranks, or practically a tent sub-division, from field ambulances 
of their divisions. A number of men was also attached to the 
casualty clearing stations for temporary duty from labour and 
other units. 

The casualty clearing stations of the Third Army receiving 



68 MEDICAL HISTORY OF THE WAR 

■ 

the wounded from the battle front had thus from twelve to 
fourteen medical officers each in addition to dental surgeons 
and chaplains who assisted in the work, and a considerable 
reinforcement of nursing sisters, R.A.M.C. orderlies, stretcher 
bearers, and men of categories unfit for the fighting line. 

The Motor Ambulance Convoys. — The motor ambulance 
convoys in the Third Army area were No. 3 at Gouy-en-Artois, 
No. 15 at Louez, north of the Arras-St. Pol road, about three 
miles from Arras, No. 24 at Aubigny and No. 16 at Frevent. 
The first three of these were placed at the disposal of the 
D.Ds.M.S. of the Vllth, Vlth, and XVIIth Corps respectively, 
and No. 16 was retained under the direct control of the D.M.S. 
An additional convoy, No. 31, from the Fifth Army was temp- 
orarily attached by orders of the D.G.M.S. It was placed by the 
D.M.S. of the Third Army at the disposal of the D.D.M.S., 
Vllth Corps, owing to the length of the journey to the casualty 
clearing stations allotted for his wounded. 

The convoys were supplemented by 45 charabancs or motor 
buses, 10 of which were given to the Vllth and Vlth Corps and 
20 to the XVIIth Corps, the remainder being kept under the 
direct control of the D.M.S. They were employed for the 
transport of sitting cases to Douliens, Frevent and St. Pol ; 
and were still further supplemented by as many lorries as could 
be made temporarily available from army or corps resources 
and casualty clearing stations, in order to carry out the general 
policy of bringing as many of the sitting-up cases to the units 
on the main line of railway running through Douliens, Frevent 
and St. Pol, where they could be loaded into temporary ambul- 
ance trains and thus leave the lines leading to the casualty 
clearing station groups free for the permanent ambulance trains. 

Evacuation from Oasualty\Clearing Stations. 
The Third Army directorate of railway transport had garaged 
eight ambulance trains and three temporary ambulance trains 
in or near the casualty clearing stations before the attack was 
launched. During the first twenty-four hours of the battle, 
from 9 a.m. on the 9th April to 9 a.m. on the 10th April, all 
these ambulance trains and one of the temporary ambulance 
trains were available and took back wounded from the Third 
Army area. A maximum of journeys was reached during the 
next forty-eight hours, when twenty ambulance and five tem- 
porary ambulance train journeys were made during that time. 
The general arrangements for the running of the trains proved 
remarkably efficient, and there was never at any time delay or 



THE BATTLE OF ARRAS, 1917 69 

difficulty in keeping the casualty clearing stations free from 
congestion. Altogether during the period of active hostilities 
in April the ambulance trains made 129 journeys and temporary 
ambulance trains fifteen to the area of the Third Army. The 
only mishap that occurred was on the 11th April, when an 
ambulance train from Warlincourt Halte came into collision 
with another train, but was able to continue the journey, 
although the line was blocked for several hours. 

Medical and Surgical Supplies. 

Advanced depots of medical stores were placed at Savy, near 
Aubigny, Frevent, and Doullens ; and there was no lack of 
medical and surgical equipment or appliances. 

Ample reserves of stretchers and blankets were also provided, 
and their distribution followed the method generally employed 
in previous battles ; 2,000 stretchers were issued by the D.M.S. 
of the Army as a reserve to each corps D. D.M.S. and 500 to 
each casualty clearing station. These arrangements were built 
up in association with more detailed preparations of the 
D.Ds.M.S. of each of the corps and the A.Ds.M.S. of divisions. 

The Casualties. 

The total casualties received into the Third Army medical 
units during April were 2,002 officers and 43,476 other ranks, 
of whom 135 officers and 3,722 other ranks were from other than 
Third Army formations. As in practically all the battles of the 
Western front, the maximum number of wounded was during 
the first twenty-four hours, when 445 British and 6 German 
officers, and 9,719 British and 1,350 German other ranks were 
admitted. The casualties amongst the personnel of the 
medical services were severe. Six officers and 57 other ranks 
were killed and eighteen officers and 278 other ranks wounded. 

The Meiical Services of the Vllth Corps. 

The Vllth Corps was composed of the 21st, 30th, 56th 
and 14th Divisions, and held a line from Croisilles to the 
southern outskirts of Arras. A corps main dressing station was 
established at Gouy-en-Artois in twenty-seven Nissen huts ; 
and a walking wounded collecting station at Agny for the three 
divisions on the left and in the centre, and at Boiry for the 21st 
Division on the right of the attack. Each division opened an 
advanced dressing station, the 21st at Boiry Ste. Rictrude, the 
30th at a position north of Boiry, the 56th at Achicourt, and 
the 14th at Rouville. The two former were a considerable 

(10134) G* 



70 



MEDICAL HISTORY OF THE WAR 




Advanced dressing station at Henin. Ornamental work by orderlies. 




Main entrance to an advanced dressing station in a dug-out at Henin. 



. / 



if 








Road entrance to advanced dressing station in a dug-out at Henin. 



THE BATTLE OF ARRAS, 1917 



71 



distance from the front line, some four or five miles, but the 
two latter and the corps walking wounded collecting station 
at Agny were within a short distance of the communication 
trenches. A large corps rest station for the sick was formed at 
Barly between Warlincourt Halte and Avesnes-le-Comte. 

The casualties in the corps were comparatively slight on the 
first day of the attack ; the numbers received into the field 
ambulances being as follows between 6 a.m. of the 9th April 
and 6 a.m. of the 10th April : — 





Officers. 


Other ranks 


21st Division 


.... 9 


379 


30th Division 


24 


396 


56th Division 


26 


522 


14th Division 


32 


553 


Other formations 


4 


89 


Germans 


1 


104 



Total 



96 



2,043 



The D.D.M.S. of the corps, Colonel Swan, visited all the 
divisional advanced dressing stations, and corps and divisional 
walking wounded collecting stations during the 10th April and 
found them empty or practically empty, a fact which demon- 
strated the ease with which these numbers could be cleared 
from the battlefield by the general system of evacuation, which 
had now become a routine operation after the experiences of 
the Somme battles. 

Until the 23rd April the work thrown on the medical services 
of the Vllth Corps continued to be comparatively light. In 
addition to the ten charabancs placed at his disposal by the 
D.M.S. of the army, Colonel Swan had seventy lorries during 
the first twenty-four hours from the corps, and was able to 
clear all his walking wounded from Agny to Doullens, a distance 
of twenty miles, with the greatest ease. For the clearing of the 
main dressing station to the casualty clearing stations he had 
No. 3 M.A.C. and a section of No. 31 M.A.C., the cars of which 
were brought up to Gouy. 

Both the corps collecting station at Agny and the main 
dressing station at Gouy were moved forward on the 13th 
April, the former to Mercatel and the latter to Boiry Ste. Ric- 
trude, the corps rest station moving from Barly into the huts 
left at Gouy by the main dressing station ; but, although sites 
were being selected near Boisleux-au-Mont for the group of 
casualty clearing stations at Warlincourt, the move to the new 
site did not take place until after the battle. In view, however, 
of the long distance of Warlincourt from the front, an advanced 



(10134) 



G** 



Tl 



MEDICAL HISTORY OF THE WAR 



operating centre, as already noted, was opened towards the 
end of April at the corps main dressing station at Boiry Ste. 
Rictrude, but moved later into Nissen huts on the road from 
Arras, near Ficheux. The field ambulance there was reinforced 
by surgical teams and nursing sisters. 

At this time the divisions of the Vllth Corps were preparing 
for a renewed attack on the 23rd April. The 14th Division had 
been relieved in the line by the 50th and the 30th by the 33rd 
Division after the earlier fighting of the 9th to 11th April ; the 
21st Division was also relieved and its front taken over by the 
33rd Division on the 15th April, the corps then having three 
divisions in the line. The 30th Division again came into line 

Battle of Arras. 
-Apr*j~ yn_ Corps Front ^ -/s/?- 




if Caa/zg Maw Dressing Station. Q Pvsm-. Adv. D/Z£ssins Station. ACocas hULJONa hhoivoeoC<M-i~5TA. 
***y.Af>fi>ao*af*ATc 3/&t/&h t-t/vec oh Apr.ii- ST.". 

Scale of Mil.es 

I O \ 8 3-^5 
• + 4 1 1 



on the 20th April, relieving the 56th Division ; and the attack 
on the 23rd April was carried out by the 33rd, 30th and 50th 
Divisions. The losses were only slightly heavier than in the 
attack of the 9th April, the wounded received into the divisional 
medical units being as follows during the twenty-four hours : — 



33rd Division 
30th Division 
50th Division 
Other formations 
Germans 



Officers. Other ranks. 

34 551 

23 529 

52 896 

3 71 

2 56 



Total 



114 



2,103 



The corps main dressing station was capable of handling the 
casualties without difficulty. It had been organized to deal 
with 1,400 at a time, as well as to perform operations on and 



THE BATTLE OF ARRAS, 1917 



73 



retain abdominal and other urgent cases. As on the 9th April, 
the D.D.M.S. obtained a large number of lorries from the corps, 
and these, together with 18 charabancs, were employed for 




Collecting post for cars at St. Martin-sur-Cojeul, near Henin, 1917. 

clearing the walking wounded collecting station. For clearing 
the main dressing stations the D.D.M.S. had, as before, No. 3 
M.A.C. and a section of No. 31 M.A.C. 




Reception ward of advanced dressing station at Henin. 

The 14th and 21st Divisions returned to the line in relief of 
the 50th and 23rd Divisions after this action ; and the 18th 
Division from the Fifth Army came into the corps area and 



74 MEDICAL HISTORY OF THE WAR 

relieved the 30th Division at the end of the month. The 
casualties, however, were comparatively few after the attack 
of the 23rd April, and there was little further to record affecting 
the medical services on the Vllth Corps front. 

The Medical Services of the Vlth Corps. 

The Vlth Corps held a narrow front of some 2,700 yards from 
the Cambrai road to the Scarpe, with the city of Arras behind 
it. The attack on the 9th April was launched by the 3rd, 12th 
and 15th Divisions, with the 37th Division and the 3rd Cavalry 
Division ready to pass through and continue the preliminary 
success. The chief problem in the medical preparations de- 
pended on the fact that all traffic had to pass through Arras. 
Consequently, it was anticipated that when the 37th and 3rd 
Cavalry Divisions commenced to pass through it would not 
be possible to get the wounded back to the casualty clearing 
stations during the first thirty-six hours of the battle. There 
were only two main roads leading from the town, the St. Pol 
road on the north-west, and the Doullens road leading to the 
Dainville-Warlus road on the west. Both these roads were 
likely to be congested with the traffic entering the town. 

The D.D.M.S. of the Corps, Colonel H. N. Thompson, there- 
fore made special preparations for the retention of wounded in 
what he designated advanced dressing stations, although in 
reality they were equipped and manned to perform the functions 
of main dressing stations, with the full resources of the field 
ambulance tent divisions, supplemented by other material 
specially obtained. They were established by each of the 
divisions in caves, cellars and basements of buildings, protected 
as strongly as possible with sandbags and overhead bursting 
courses, on the north-eastern, eastern and south-eastern out- 
skirts of the town. The chief of these was in a large subterranean 
cave, from which stone had been excavated for building the 
town in the 16th century. It was close to the 3rd Division 
trenches and only 800 yards from the front line. Two inlets 
for stretchers were tunnelled into it from the communication 
trenches, and an outlet tunnelled out from the back into the 
Rue St. Quentin, where an approach was constructed for ambu- 
lance cars (see plan). This cave, to which the name of 
' Thompson's Cave " was given, was fitted with electric light 
and a piped water supply and was able to accommodate 700 
wounded on stretchers in two tiers, together with dressing and 
operating rooms, kitchens and latrines. It was manned by 
field ambulances of the 3rd Division, but was in fact a corps 



THE BATTLE OF ARRAS, 1917 



75 



dressing station for severely wounded requiring urgent attention. 
Unfortunately on the 11th April a large shell exploded on the 

Plan of "Thompsons Cave". 
Battle of Arras, April 1917. 




top of the cave and burst the water main, causing the roof to 
fall in in two places. Although no casualties occurred, it was 



76 



MEDICAL HISTORY OF THE WAR 



impossible to continue the use of the cave as a dressing station ; 
and two new dressing stations were then opened in the town, 
one in the Ecole Normale and the other in the Hopital St. Jean, 
the latter becoming an advanced operating centre for abdominal 
wounds with special surgical teams attached to it, until it too 
in its turn had to be abandoned subsequently owing to shell fire. 
Fortunately the congestion of the traffic in Arras did not delay 
unduly the transfer of wounded from the dressing stations to 
the casualty clearing stations at Agnez-les-Duisans. 



Battle of arras. 
-Ap-n//- 3^j Corps Front. 
— i 



- /9/7- 




Q Adi> 'De£ss/NG Stat/on osz Aov. Post. 
A Cax/zs IM\l.k;mg Woc/md£dCcu_i-. Pbsrr. 
jg CoxpSMaw Do.£ss/^g Station. 



A corps collecting station for walking wounded was prepared 
in an extensive bomb-proof shelter of the bastion on the north- 
west corner of the town. It could shelter some 450 wounded 
at one time. Preparations were made in it for receiving, 
recording, feeding and dressing the walking wounded as they 
straggled in. Moats and a covered way bristling with guns 
surrounded the bastion, and the hopes of clearing the wounded 
by wheeled traffic from it were not promising. A duck-board 
path leading to the Dainville road was consequently made 
across the moats, and the wounded walked to the horsed ambu- 
lance wagons and motor buses drawn up behind the artillery 



THE BATTLE OF ARRAS, 1917 



77 



positions. The lightly wounded were thus conveyed to Warlus, 
whence they were taken by light railway to Avesnes-le-Comte 
and Frevent. 

Pooling of Ambulance Cars. — Consequent upon the arrange- 
ment by which the divisional dressing stations were formed 
close to the communication trenches and the wounded taken 
from them direct to the casualty clearing stations, there was 
no normal zone of work for the motor ambulance transport of 
divisional field ambulances. Colonel Thompson consequently 
withdrew the motor ambulance cars from the field ambulances 
and pooled them with the cars of No. 15 M.A.C. He employed 



* 








>•' 



Trench entrance to advanced dressing station, Wancourt. 



them in clearing the dressing stations in Arras to Agnez-les- 
Duisans during the first phase of the battle. But when the line 
of the Vlth Corps advanced, as it did by the 11th April, to some 
five miles east of Arras, advanced dressing stations had to be 
thrown out along the Cambrai road and the Scarpe valley 
towards Bois-des-Boeufs, Feuchy Chapel and Feuchy, leaving 
the tent divisions of the field ambulances as main dressing 
stations in the original positions in Arras. When this occurred, 
the D.D.M.S. restricted the work of the convoy to its normal 
function of clearing the dressing stations in Arras, and ordered 
the divisional ambulance cars to be restored to their units for 
their legitimate work of clearing the advanced to the main 
dressing stations. The disentanglement of the pooled cars, 



78 MEDICAL HISTORY OF THE WAR 

however, from the convoy proved not so simple as was antici- 
pated, and there was much delay in clearing some of the 
advanced dressing stations in consequence of the field ambulance 
cars failing to return to their units at once. 

This was specially so in the 37th Division, which attacked and 
captured Monchy-le-Preux on the 11th April. At 4.30 p.m. the 
A.D.M.S. of the Division was informed by the D.D.M.S. of the 
Vlth Corps that his motor ambulance cars would be returned to 
the division, and that No. 15 M.A.C. would in future only clear 
the dressing stations in Arras. The division had advanced 
dressing stations at Feuchy Chapel, full of wounded, in a con- 
crete German aid post, and at Bois des Boeufs ; but no ambu- 
lance cars had reached them since noon. There were no signs 
of the cars at 9.45 p.m. and a telephone message to the D.D.M.S. 
did not have any effect. A despatch rider was sent to the motor 
ambulance convoy, followed by an officer at 10 p.m. urging the 
return of the cars ; but it was not till 1.30 a.m. of the 12th April 
that their arrival was reported to the A.D.M.S., when they were 
at once sent forward to the advanced dressing stations. 

The incident raises a tactical question of some importance in 
the handling of the ambulance transport of medical units during 
a battle. In order to employ the ambulance cars of field ambu- 
lances in bringing back wounded from the dressing stations to 
the casualty clearing stations, when they would otherwise have 
been idle, was it necessary to pool them with the motor ambu- 
lance convoy cars and place them under the officer commanding 
the convoy ? Could they not equally well have assisted in 
the work of clearing the dressing stations in Arras under the 
direction of the A. Ds. M.S. of divisions and the officers command- 
ing the units to which they belonged ? Had this course been 
adopted the clearing of the advanced dressing stations thrown 
out along the Cambrai road would have commenced auto- 
matically under the divisional A.D.M.S. without his having to 
wait for the disentanglement of his field ambulance cars from 
the convoy and their return to the division. 

Instances ol a similar nature occurred during the war. They 
emphasized the importance of avoiding the practice of pooling 
the field ambulance transport with that of motor ambulance 
convoys, a practice to which the D.G.M.S. administrative staff 
was consistently opposed. 

Clerical Work at C.C.Ss. — Colonel Thompson made another 
innovation in the work of his medical services during the battle. 
He regarded the group of casualty clearing stations at Agnez- 
les-Duisans as his corps main dressing station and attached to 



THE BATTLE OF ARRAS, 1917 79 

them a clerical staff from field ambulances of each of the 
divisions for the purpose of recording the admissions, such 
records being purposely omitted at the dressing stations in 
Arras. The names and particulars of each wounded man 
arriving at the casualty clearing stations were entered by this 
staff in the small forms supplied for the purpose.* These were 
periodically separated into bundles according to divisions and 
sent to the A.D.M.S. of the division concerned, who had the 
entries then made in the field ambulance admission and discharge 
books. A similar staff of clerks was appointed to the corps 
walking wounded collecting station, but the entries were made 
there direct into the admission and discharge books. 

Interchange of Equipment at C.C.Ss. — Special arrangements 
were also made by Colonel Thompson for an interchange of 
stretchers, blankets, hot-water bottles and such instruments as 
artery forceps, between the dressing stations and the casualty 
clearing stations by means of a check ticket system. Each 
ambulance car driver handed in one half of a ticket with the 
details entered on it of the articles brought back with the 
patients, and obtained the corresponding number of articles on 
handing in the second half to an issuing store on his returning 
to the front. 

These general arrangements in the Vlth Corps are of interest 
and originality, and were undoubtedly advantageous in the 
early phases of the battle, when the jumping-off place for the 
divisions engaged was the town of Arras. Wounded were able 
to reach the casualty clearing stations from Arras in some cases 
within two hours of being wounded ; and there was considerable 
saving of dressings and time. But as the front advanced the 
tactical situation for the medical services became more normal 
in character. Echelons of advanced and main dressing stations, 
with separate zones of work for divisional and convoy motor 
ambulance cars, were established in accordance with the 
normal system of evacuation. 



The Cavalry Advance to Monchy-le-Preux. 

The operations of the Cavalry Corps, during the battle, as 
affecting the medical services, centre in the work of the 3rd 
Cavalry Division. This cavalry division moved to the north of 
Arras at 10 a.m. on the 9th April preparatory to carrying on 
the advance between the Scarpe and the Arras-Cambrai road 

* A.F. W.3210. 



80 MEDICAL HISTORY OF THE WAR 

to the area beyond Monchy-le-Preux, while the 2nd Cavalry 
Division followed up the advance south of the road and the 
1st Cavalry Division the advance north of the Scarpe. The 3rd 
Cavalry Division went into action on the following day, but 
withdrew behind Arras again with few casualties. On the 11th 
April its 6th and 8th Brigades again joined in the attack on 
Monchy-le-Preux, and reached that village in support of the 
attacks earlier in the day by the 37th Division. Towards 
evening, as no further opportunity was given it for cavalry 
operations, it was withdrawn, after suffering heavy casualties, 
chiefly in the 10th Hussars and Essex Yeomanry of the 8th 
Cavalry Brigade. 

Two squadrons, however, of the 10th Hussars and part of the 
8th Machine Gun Squadron remained in the village until relieved 
on the night of the 12th/ 13th April. A regrettable incident 
then occurred in connexion with the work of collecting the 
wounded to the dressing stations further back. 

In order to make intelligible the general disposition of the 
medical services with the cavalry divisions during this action a 
description of the organization of their field ambulances is neces- 
sary, as it differed essentially from that of the field ambulances 
of divisions. It will be recalled that during the advance to 
the Aisne in 1914 most of the cavalry field ambulances were 
organized as light and heavy sections, the former marching 
with and attached to cavalry brigades, and the latter marching 
behind the ammunition columns. When motor ambulance cars 
replaced the heavy horse-drawn ambulance wagons at a later 
period, this arrangement of light and heavy sections became a 
definite organization, the light horsed ambulance wagons 
remaining with the light sections and the motor ambulance 
cars with the heavy section. The light section was organized 
to provide an advanced dressing station, and the heavy section 
a main dressing station, but some of the cavalry field ambu- 
lances had prepared a special mounted section, the organization 
of which was brought to the notice of the G.O.C. of the Cavalry 
Corps, in a long memorandum by his D.D.M.S., Colonel F. J. 
Morgan, in February 1917. The intention was that there should 
be what he called a " pack mounted section " with each cavalry 
field ambulance capable of affording aid to wounded during a 
cavalry action on occasions when the whole resources of the 



THE BATTLE OF ARRAS, 1917 81 

cavalry field ambulance would not be available.* It was 
anticipated that occasions might arise when cavalry would 
advance through a gap rapidly and far, over a trench system 
where ambulance transport could not follow, or when cavalry 
regiments would be widely separated from such assistance as 
could be afforded by cavalry field ambulances. The only 
means then of removing the wounded would be by hand 
carriage, and the " pack mounted section " was to carry along 
with the advancing cavalry brigades stretchers, medical equip- 
ment, water and blankets. These pack mounted sections 
were intended to form brigade collecting posts in touch 
with regimental medical officers, regimental aid posts, and 
the on-coming light moving sections, and to keep wounded 
collected in groups near roads until the state of the roads and 
the military situation permitted their being cleared by the 
light moving section ambulance wagons to the advanced 
dressing station. 

It was this organization of cavalry field ambulances that 
went into action with the 3rd Cavalry Division on the 10th and 

* Such a section for a British cavalry field ambulance was to consist of 

2 officers, 10 mounted orderlies, 12 riding horses and 4 pack mules, each of 

3 of the pack mules to carry 4 stretchers and 8 blankets, and the fourth 
12 gallons of water in 6 petrol tins in 2 boxes, as well as medical comforts, 
splints and dressings. 

The pack mounted section of an Indian cavalry field ambulance was slightly 
different, owing to the difference in its original organization. A mounted 
section had for a long time been organized by the 5th (2nd Indian) Cavalry 
Division, and consisted of 2 officers, 1 assistant surgeon, 20 other ranks, with 
22 riding horses and 7 pack mules. Two of the pack mules were spare mules. 
Two of the others carried two Miller-James wheeled stretcher carriers each, 
a third rations and medical comforts, a fourth dressings and splints, and a 
fifth water. Four special stretchers for mounting on the stretcher carriers 
were constructed by removing the traverses and poles of the field stretcher 
and inserting the latter when in use into slots in the canvas body, and keeping 
them separate by a removable bar and ring traverses. The poles, when the 
stretcher was not in use, were carried lance fashion in a bucket attached to 
the stirrup of the mounted stretcher bearers, each of two bearers carrying a 
pole, and one of them also the canvas and traverses. The 2nd Indian Cavalry- 
Division ambulances had commenced this organization shortly after their 
arrival in France, and it was after the Indian Cavalry Divisions had been 
amalgamated with the Cavalry Corps as No. 4 and No. 5 (Indian) Cavalry 
Divisions in September 1916 that the D.D.M.S. of the corps took up the 
question of pack mounted sections as a definite war establishment for cavalry 
some months later. 

The composition, however, of the pack mounted sections varied according 
to the views of the officers commanding cavalry field ambulances, and the 
D.D.M.S. of the Cavalry Corps, just before the Arras operations, arranged 
that the pack mounted section should be formed of a minimum of 2 officers, 
1 N.C.O., 5 orderlies and 2 pack horse leaders, with 10 riding and 2 pack 
horses. One of the pack horses was to carry 8 light jointed stretchers, and 
the other 6 gallons of water in 3 petrol tins of 2 gallons capacity each, dressings 
and medical comforts. Dressings and appliances were also to be carried in 
saddle bags on the orderlies' horses. 



82 MEDICAL HISTORY OF THE WAR 

11th April. The following order was issued on the 8th April 
by the General Staff of the division : — 

" Medical Arrangements for ' Z ' day. 

" (a) All heavy sections C.F.As. will remain concentrated at Gouy 
under the orders of the A.D.M.S. 

(b) Pack mounted sections will move with brigades under all 
circumstances. 

(c) Light sections C.F.As. will be collected as soon as the division 
has carried out its first concentration, park just off the road in P. 12. a. 6. 6* 
and await orders from the A.D.M.S. 

(d) An advanced division dressing station will be established on the 
main Arras-Cambrai road about Les Fosses Farm, N.ll.b.9.4,f when 
the division moves forward to its first objective. 

(e) Divisional collecting station for walking cases will be established 
in the caves in Arras, where the Arras-Cambrai road runs into Arras." 

On receipt of this order, which was attached to the divisional 
orders of the same date at 11 a.m., the A.D.M.S. of the 3rd 
Cavalry Division (Lieut. -Colonel D. Lawson) issued the following 
R.A.M.C. Concentration Order No. 1, and Operation Order 
No. 2 :— 

" Medical Arrangements, 3rd Cavalry Division. 
Concentration Order No. 1 . 

1 . After zero hour -f- 2 on ' Z ' day the division will be standing to 
at one hour's notice. 

2. When the division moves one light ambulance wagon and a corporal 
R.A.M.C. as wagon orderly will be detailed by each cavalry field ambu- 
lance to accompany the regiments of its brigade on their march to the 
eastern outskirts of Arras. 

The wagon will follow closely after the rear regiment of the brigade, 
will collect all casualties and take them to the dressing station in the 
Grande Place, and then endeavour to pick up the brigade again. 

At the railway crossing at the east outskirts of Arras the wagon will 
return and park in some available sheltered spot just off the main road, 
half-mile on the west side of Arras. 

3. On the order to move being received the light sections in the order 
No. 8 C.F.A., No. 6 C.F.A., No. 7 C.F.A., will follow the 7th Brigade 
and park just off the road at the X road half-kil. N.N.E. of the X in 
FOSSEUX (Lens 11, 1/100,000) and await further orders from the 
A.D.M.S. Horses harnessed in but poles down. 

Wheeled stretcher carriers will be kept ready for early use. 

4. Combined heavy sections will remain in billets at Gouy ready to 
move at half-hour's notice. 

5. Motor ambulance cars will move independently from Gouy not 
sooner than one hour after the light sections have moved and concentrate 
with light sections. 

6. A subsequent move forward will take place with a view to bringing 
the division into a further position of readiness. 

(a) In this move A.l Echelons of Brigades, the Division Ammunition 
Column and A. 2 Echelons will move into the area vacated by 
7th Cavalry Brigade. 

* Between Fosseux and Wanquetin, and between eight and nine miles 
west of Arras. 

f Just south of Monchy-le-Preux. 



THE BATTLE OF ARRAS, 1917 83 

(b) As soon as the Divisional Ammunition Column followed by A.2 
Echelon have moved off the light sections of C.F.As. in the 
Older given will follow A.2 Echelon and move before the Mobile 
Veterinary Sections. 

7. Units will clear roads and villages as far as possible when halted. 

(a) When any unit receives the order to move, it will warn the unit 

in rear of it. 

(b) As soon as the march is resumed all units will close up. 

8. Zero hour is fixed at 5.30 a.m. on 9th April, Z + 2 = 7.30 a.m. 
Issued at 1 a.m. 9.4.17." 

" Medical Arrangements, 3rd Cavalry Division. 
Operation Order No. 2. 

8th April 1917. 
Reference Map 51 B & C. (1/40,000). 
Lens 11 (1/100,000). 

1. Third Army is attacking east of Arras to-morrow. This attack 
will take place at zero hour, to be notified later. 

2. The Vlth Corps will assault the Wancourt-Feuchy line north and 
south of the main Arras-Cambrai road at approximately Z + 8 hours. 

Should this succeed the 37th Division will attack Monchy-le-Preux 
and the ground north and south of it. 

3. When Monchy-le-Preux has been seized the 3rd Cavalry Division 
will advance on its first objective, the line Vis-en- Artois-Boiry Notre 
Dame ; the 50th Infantry Brigade, 17th Division, will be following the 
3rd Cavalry Division. 

4. (a) 8th Cavalry Brigade will be moving north of Monchy to Boiry 
Notre Dame. 

(b) 6th Cavalry Brigade will be moving south of Monchy to Vis-en- 
Artois. 

(c) 7th Cavalry Brigade will be in reserve in H. 33 central (51 B).* 

5. (a) Pack mounted sections of cavalry field ambulances will 
accompany their respective Brigade Headquarters. 

The O.C., C.F.A. or O.C., Section will get in touch with regimental 
medical officers as soon as practicable and deal with casualties, collecting 
them in groups under any available shelter and near roads or tracks. 

A series of relay posts is to be established along the main Arras- 
Cambrai road, and casualties will be brought along that road and handed 
over to nearest relay party. 

(b) Light sections of C.F.As. will be concentrated in accordance with 
attached concentration order No. 1 and be prepared to move off on 
quarter-hour's notice to form an advanced dressing station under orders 
from this office. 

This dressing station will probably be in Les Fosses Farm, N.ll.b.9.4 
on the main Arras-Cambrai road. 

Light wagons will be sent out to get in touch with pack mounted 
sections as soon as possible. 

(c) Motor ambulance cars will move independently to the same con- 
centration point as light sections, where they will be divisionalized under 
charge of the senior M.T. N.C.O. and await further orders from the 
A.D.M.S. 

(d) The combined heavy sections, under command of Captain Slaney, 
R.A.M.C, will remain concentrated at Gouy, and await further orders, 
but be ready to move at half -hour's notice. 

The O.C. combined heavy sections will be prepared to send forward 
on quarter-hour's notice 2 Serjeants, 4 corporals, and 32 privates, R.A.M.C, 
to act as stretcher bearers. 

* Just north of the Arras-Cambrai road, about three miles from Arras. 



84 MEDICAL HISTORY OF THE WAR 

Seven motor ambulance cars will be sent to convey this party. It will 
be formed into 8 squads, and each squad will carry 1 long stretcher, 
1 blanket, and, if possible, 1 large water bottle or petrol tin of water. 

(e) No. 12 Sanitary Section will remain at Gouy, and will be prepared 
to follow combined heavy sections if so ordered. 

6. The A.D.M.S. will be at H.32 central (51 B).* 

7. All walking wounded from the division will be directed to the 
Bastion collecting post, Arras. Lying and sitting cases will be taken 
to the nearest infantry advanced dressing station or the ' Cave,' A.D.S., 
Arras. 

Copy No. 1 to G.S. 3rd Cavalry Division. 
No. 2 to ' Q * 

No. 3 to D.D.M.S., Cavalry Corps. 
No. 4 to File. 

No. 5 to No. 6 Cavalry Field Ambulance. 
No. 6 to No. 7 
No. 7 to No. 8 
No. 8 to O.C. Combined Heavy Sections." 

Accordingly when the 3rd Cavalry Division advanced on the 
10th April the pack mounted sections moved with brigade 
headquarters. The casualties were few, and these sections were 
able to deal with them. Stretcher bearer parties went out from 
the light sections, but they were not required, and all returned 
to the bivouacs west of Arras at 9 p.m. 

On the 11th April the pack mounted sections again went 
forward with their brigade headquarters, and at 12.30 p.m. 
the stretcher bearer party was sent along the Cambrai road to 
search the ground over which the cavalry had advanced. At 
1.30 p.m. eighteen light ambulance wagons went forward to 
Feuchy Chapel, where the stretcher squads had brought the 
wounded, and where the 37th Division had an advanced 
dressing station. 

The remainder of the light sections of Nos. 6 and 8 Cavalry 
Field Ambulances were sent out at 2.30 p.m. to form a dressing 
station as far forward as possible, but were unable to get beyond 
the Bois des Boeufs, three miles west of Monchy, where also 
an advanced dressing station of the 37th Division had already 
been established. The 3rd Cavalry Division order to form an 
advanced dressing station at Les Fosses Farm on the Cambrai 
road 1,000 yards south-west of Monchy-le-Preux could not be 
carried out. 

The D. A.D.M.S., Captain Newman, who had been sent for- 
ward by the A.D.M.S. to form an advanced dressing station 
with the light sections, visited brigade headquarters and saw 
the Os.C. of No. 6 and No. 8 C.F.As. with their pack mounted 
sections at 4.30 p.m. Heavy casualties were then known to be 

*At the Bois des Boeufs, two and a half miles from Arras on the Cambrai 
road. 



THE BATTLE OF ARRAS, 1917 85 

west of Monchy, but neither of them told him that they 
required further assistance. 

What followed is not very clear, but the A.D.M.S's. diary for 
the 11th April records that the light sections of the cavalry 
field ambulances were withdrawn with the division west of 
Arras at 9 p.m. They were working under his direct orders, 
and not under the orders of their commanding officers, who were 
at the time with pack mounted sections at headquarters of 
brigades. So far as the O.C. of No. 6 C.F.A. is concerned there 
appears to have been little difficulty. He states that after 
dusk on the 11th April stretcher bearers from the light sections 
collected wounded from the line Monchy-le-Preux-Les Fosses 
Farm, and evacuated them by the light ambulance wagons to 
infantry dressing stations, and that by 9 p.m., before the last 
regiment of the brigade was relieved, all casualties in the brigade 
had been evacuated, when the brigade moved back to billets 
on the racecourse west of Arras. 

At 5.15 p.m. the following field message was issued by the 
G.O.C. of the division : — 

" The Division will withdraw west of Arras to-night. Wheels will 
move by road and remainder of division by cavalry track and will 
bivouac on the Champs des Courses (Ref. Lens 1/100,000) just west 
of Arras. Order of march 7th Cavalry Brigade, 8th Brigade, 6th 
Brigade, IVth Brigade R.H.A., C.F.As. A.i and A.ii echelons have 
already received orders to move. Any portions of A echelons now 
with units will move under the orders of those units. 6th and 8th 
Brigades will not withdraw until relieved by units of the 12th Division. 
IVth Brigade R.H.A. will remain in present positions until 7 p.m. when 
they may withdraw. C.F.As. will only withdraw on completion of 
evacuation of wounded of division. Supply sections will meet units on 
arrival. 7th Brigade will allot bivouac areas. Divisional Report 
Centre Zero exchange G.22.d.31." 

At 5.55 p.m. the D.A.D.M.S. sent the following message to 
the A.D.M.S. :— 

" Impossible to open station at Les Fosses Farm. Am removing 
infantry and cavalry wounded from Maison Rouge dressing station on 
main road. Have sent forward stretcher squads to 6th and 8th 
Brigades and have seen Heap* and Downie*. Believe there are many 
casualties. Have also ambulance wagons on road just east of Feuchy 
picking up wounded. Many wounded just west of Monchy cannot 
be reached. Have no further information as to what is likely to 
happen in near future but think advance improbable." 

At 6.15 p.m. the D.A.D.M.S. again sent a message to the 
A.D.M.S. to the following effect :— 

" Attached withdrawal orderj is forwarded. I will remain here r untii 
wounded of division are evacuated. Please send me another motor 
cyclist in place of bearer. I will tell ambulance wagons to return here 
until I consider work is completed. I think your office can remain in 
Arras to-night. I am sending limbers back to Cavalry area Arras to- 
await light wagons." 

* Os.C. of No. 6 and No. 8 C.F.As. with the pack mounted sections, 
f Field message of 5.15 p.m. as above. 

10134) ■ h 



86 MEDICAL HISTORY OF THE WAR 

At 7 p.m. the pack mounted section of No. 7 C.F.A. reported 
to the A.D.M.S. its arrival at the racecourse, but had nothing 
further to note with reference to the day's action. 

The O.C. No. 8 C.F.A. joined his pack mounted section in a 
copse some 600 yards north-west of Monchy, where three of his 
horses, including a pack horse, were killed and two others 
wounded, rendering his pack section useless. He then came 
back with the remainder and reported the situation to the 
A.D.M.S. by a field message. About 5 p.m. he went into Monchy 
to find out the position of the wounded. There he found Captain 
Stork, the regimental medical officer of the Essex Yeomanry, 
and also Major Cowie of the R.H.G., and having satisfied 
himself of the position of the wounded he reported the facts to 
the officer in charge of the stretcher bearer party and rejoined 
his pack mounted section, returning with it at midnight to the 
racecourse. 

Neither the A.D.M.S , who ordered the withdrawal of the 
light sections, nor his D. A.D.M.S., who was with them on the 
Arras-Cambrai road and in touch with the advanced operating 
centre, appears to have been aware that wounded of the 8th 
Cavalry Brigade were still awaiting evacuation from Monchy, 
and consequently there were neither pack mounted sections nor 
light sections of the 3rd Cavalry Division nearer than the race- 
course on the west of Arras during the night of the 11th/ 12th 
April. The 12th Division was then taking over the front from 
the 37th Division and moving into the advanced dressing 
stations at Bois des Boeufs and Feuchy Chapel. The A.D.M.S. 
first received information of wounded still being in Monchy from 
the D. A.D.M.S. of the Cavalry Corps at 3 p.m. on the 12th 
April, and at 6 p.m. of that day the D.A.D.M.S. of the corps 
himself went to Monchy with a stretcher party, bringing back 
the O.C. of the 10th Hussars and thirty other wounded during 
the night of the 12th/ 13th, and reporting that some forty more 
were in the cellars there. These were eventually got out the 
following night by a large party of officers and dismounted men 
and by motor ambulance cars which went forward to Feuchy 
Chapel. About eighty wounded were brought back. Another 
party went into Monchy on the night of the 14th/ 15th April, 
but found only one cavalry wounded remaining there. 

The bearers and transport of the field ambulances of the 12th 
Division also helped to clear numbers of cavalry wounded out 
of Monchy. The A.D.M.S. of the division was informed of the 
wounded being there by the G.O.C. of the 3rd Cavalry Division 
and by the G.O.C. of one of the brigades of the 12th Division 






THE BATTLE OF ARRAS, 1917 87 

at 4 p.m. on the 12th April. He then gave orders to No. 37 
Field Ambulance and all the bearers of the division to continue 
clearing Monchy-le-Preux until 6 a.m. on the 13th April. It 
was not possible to carry on this work in daylight owing to the 
approaches being under enemy observation and fire. 

The fact of so many of the cavalry wounded having been left 
in Monchy during the night of the 11th/ 12th April brought at 
the time considerable criticism on the working of the medical 
services. The chief cause appears to have been the want of close 
touch between the A.D.M.S. and his divisional staff, from whom 
he had no information of the conditions in Monchy at the time 
the cavalry division was withdrawn. At the same time, as both 
the officers commanding No. 6 and No. 8 C.F.As. and the officer 
in charge of the bearer party seem to have known that there were 
wounded in Monchy on the night of the 11th April, it is difficult 
to understand why the information did not reach the A.D.M.S. 
through them, although they may not have been aware of the 
large number of wounded in Monchy or the urgency of clearing 
them during the night, or may possibly have understood that 
the 12th Division medical units, which were taking over the 
area, would clear the battlefield, notwithstanding the fact that 
the orders of the 3rd Cavalry Division made its field ambulances 
responsible for clearing the wounded before they withdrew. 

This incident brings out certain lessons regarding the em- 
ployment of the medical services with cavalry. The occasion 
was one of the very few on the western front when a cavalry 
division went into action otherwise than as dismounted cavalry. 
The chief lesson appears to have been the importance of a close 
touch being maintained between the officers commanding the 
cavalry field ambulances and the regimental medical officers in 
front and the stretcher bearers, ambulance transport and dress- 
ing stations behind. This duty was the duty of the officer 
commanding the pack mounted section of the ambulance. 
The O.C. of No. 8 C.F.A. had done what he considered necessary 
by finding out the position of the wounded in Monchy-le- 
Preux, getting in touch with the regimental medical officers 
there, and reporting the facts to the officer in charge of the 
'stretcher bearer party, but apparently concluded that he had 
no further responsibility in bringing the wounded back. That 
this was a correct estimate of his responsibility is doubtful. 
The A.D.M.S. of the division had taken control of all sections 
of the field ambulances except the pack mounted sections. It 
is obvious, however, that he would not have permitted the 
light sections to be withdrawn during the night of the 11th/ 12th 



88 MEDICAL HISTORY OF THE WAR 

April had he been informed of the situation. Neither his 
D. A.D.M.S., who was with the light sections, nor the officer in 
charge of the stretcher bearers, sent him this information, nor 
was he told of it by the staff of the division. His position was 
with what was known as A. echelon and not with the advanced 
report centre ; and A. echelon appears to have remained 
far back during the whole action. In fact the A.D.M.S. himself 
went forward to Arras in order to be in closer touch with what 
was happening, and was there when the orders for the final with- 
drawal of the cavalry were issued. There was thus a want of 
direct touch in two directions, one between the A.D.M.S. and 
the staff of the advanced report centre, and the other between 
the A.D.M.S. and the combined light sections of the cavalry 
field ambulances which he undertook directly to control. 
These facts come out fairly clearly from the documents and 
orders, and show how unwise it is to dissociate the officei 
commanding a cavalry field ambulance from the responsibility 
of complete control of the whole of his unit during an action ; 
and for the A.D.M.S. to be at the same time dissociated from 
the general staff. 

The fact, however, that there were large numbers of woundec 
in Monchy after the 3rd Cavalry Division was withdrawn 
appears to have been unknown at the advanced report centre 
at the time. The D. A.D.M.S. was in touch with this centre 
during the day, and no notice of these casualties reached him. 

The incident had one good effect, for on subsequent occasions 
the A.D.M.S. remained at the advanced report centre, and 
attended all staff conferences. Previously he had not been 
ordered to attend these. 

The A.D.M.S. after the action reported to the D.D.M.S. oi 
the Cavalry Corps that he had come to the conclusion, aftei 
conversation with officers commanding his cavalry field ambu- 
lances, that the pack mounted section was useless, and a waste 
of officers, men and horses. As regards its equipment, the con- 
tents of saddle bags were not used at all. He stated that the 
cavalry could never have to work under harder conditions, and 
it was therefore useless to carry these bags and their contents. 
The stretchers being tied in a bundle on the pack saddle with 
blankets necessitated the whole load being undone to get one 
stretcher. In one case this resulted in all being left on the ground 
owing to shell-fire. They were recovered later. The method of 
carrying the water in petrol tins in boxes was a failure. The 
horses had considerable difficulty in getting over the muddy 
ground, and had to follow at a distance. The boxes were 



THE BATTLE OF ARRAS, 1917 



89 



not strong enough, the petrol tins broke through them, and the 
water was not used. 

With regard to stretchers, there was considerable difficult y 
in getting the poles through the canvas when the canvas got 
wet and when working in a hurry. Besides, different parts of 
the stretchers were being carried on two horses, and they might 
not be together when the stretcher was wanted. The A.D.M.S. 
also considered that eight stretchers were more than could be 
used by the small number of men in the mounted section. He 
suggested that instead of the pack mounted section, the best 
plan would be to bring up about seventy-five stretchers and 
blankets in the lorry of the divisional sanitary section, and 




An advanced dressing station at St. Nicolas on the Arras Front. 



after an action distribute them to men, obtained from regiments, 
for collecting and removing the wounded. 

The Medical Services of the XVIIth Corps. 

The divisions of the XVIIth Corps, 9th, 4th, 34th and 51st, 
fought on the line between Arras and the Vimy Ridge along 
the Scarpe valley. The D.D.M.S., Colonel Kirkpatrick, had 
formed a corps main dressing station with tent divisions of the 
field ambulances at Haute Avesnes, where there were huts 
erected by the French when they occupied the area in 1915. 
These had been supplemented by tents and Nissen huts. Ad- 
vanced dressing stations were prepared at St. Nicolas, St. 
Catherine, the northern suburbs of Arras, and at Anzin 

(10134) K* 



90 



MEDICAL HISTORY OF THE WAR 



St. Aubin, three miles north-west of Arras, where a walking 
wounded collecting station was also prepared. A corps 
rest station was formed at Savy-Berlette near Aubigny. 
Divisional rest stations were also formed for the division on 
the left at Caucourt and for the division on the right at Ferme 
Doffine. The Savy rest station was used generally by the corps, 
but chiefly by the two central divisions, one in the line and 
one in reserve. No. 24 M.A.C., placed at the disposal of the 




Advanced Dressing Station at St. Nicolas 
Battle of Arras, 1917. 



D.D.M.S., was stationed between Aubigny and the Arras-St. 
Pol road, a large reserve of blankets being stored with it. 
Trollies for use on the light railway for bringing ammunition 
and supplies to the trenches were adapted to carry back one 
stretcher case each on the return journey. 

Heavy artillery had unfortunately been placed close to 
the walking wounded collecting station at Anzin, with the 
result that two or three days later, on the 30th March, con- 
siderable damage was done by an enemy shell which entered 
the roof of the R.A.M.C. billet and exploded. Other shells also 
fell near. 



THE BATTLE OF ARRAS, 1917 



91 



Twenty buses or charabancs were placed at the disposal 
of the D.D.M.S. for evacuating the walking wounded, the 
intention being to take them back to No. 12 Stationary 
Hospital, St. Pol. Empty lorries returning to railhead were also 
to be used by the walking wounded. 

The casualties were heavy on the first day of the battle. By 
6 p.m. of the 9th April 111 officers and 2,065 other ranks were 
collected. Evacuation proceeded so well, however, that the 
main dressing station and the walking wounded collecting 
station were practically clear then. From 6 p.m. of the 9th 
April to 6 a.m. of the 10th 77 officers and 2,101 other ranks 



Battle of Arras, April 19 17. 
Scarpe Valley Operations. 




were cleared. The attack had been launched by the 9th, 34th 
and 51st Divisions ; the 4th Division passed through the 9th 
Division and carried on the attack, capturing Fampoux the 
same day. The wounded collected from 6 a.m. to 6 p.m. on 
the 10th April were then comparatively few, 30 officers and 
628 other ranks. The number of walking wounded was, as 
anticipated, by that time small, and the chief congestion was in 
the corps main dressing station. In order to assist No. 24 
M.A.C. in clearing it, 15 cars of No. 31 M.A.C. were attached to 
it by the D.M.S. of the Army. 

On the 13th April the 51st Division on the corps left was 
relieved by the 2nd Division of the XHIth Corps from the First 



(10134) 



H** 



92 MEDICAL HISTORY OF THE WAR 

Army, and Anzin then came into the First Army area. The 
XVIIth Corps walking wounded collecting station was aban- 
doned and divisional walking wounded stations formed further 
in advance. 

On the 14th April the 34th Division sector was taken over by 
the 63rd (R.N.) Division, also of the Xlllth Corps, and the 
XVIIth Corps front was shifted further south along the valley 
of the Scarpe, the front line being held by the 4th and 51st 
Divisions, with an advanced dressing station and walking 
wounded collecting station at St. Nicolas, and main dressing 
station as before at Haute Avesnes. 




Street in St. Nicolas with ambulance cars. Battle of Arras 1917. 

On the 20th April the 37th Division, which after the capture 
of Monchy had been resting in the back area, relieved the 4th 
Division, and its field ambulances took over the walking 
wounded collecting station, the main dressing station and corps 
rest station. 

The 51st and 37th Divisions attacked on the 23rd April. 
Up to 6 p.m. 36 officers and 1,027 other ranks were collected to 
advanced dressing stations at St. Nicolas and east of St. 
Laurent-Blangy, and 63 officers and 1,266 other ranks during 
the succeeding twenty-four hours, the 51st Division being then 
relieved by the 34th. The attack was resumed on the 28th 
April, but with fewer casualties. For the subsequent operations 
on the Arras front the D.D.M.S. arranged for petrol tractor 
trollies to run between Athies and Arras on the light railway 



THE BATTLE OF ARRAS, 1917 



93 



along the tow path on the north bank of the Scarpe. Three 
trains carrying sixteen stretchers each were organized for this 
purpose. 

When the XVI I th Corps front had advanced to Roeux, six 
pontoons were placed on the Scarpe between Fampoux and 
Athies locks. They were coupled together in pairs, and worked 
by the divisional R.E., each couple taking twelve stretcher 
cases. They proved of the greatest assistance in getting back 
severely wounded over the stretch of country between Fampoux 
and Athies. The wounded were brought to Fampoux and Fam- 
poux Lock by relays of stretcher bearers and wheeled stretchers. 
From Fampoux itself they went back in ambulance cars and 
from the lock in pontoons to Athies Lock, where they were 
transferred to ambulance cars, and thence through a collecting 
post at L'Abbayette and an advanced dressing station at 



E>attle of- Arras 

Px-AM OP *ST*/V£>s4AZ£> R..A.R 0VGOUT USEO &V 



&vGO<j-r //v 




St. Nicolas to the main dressing station at Haute Avesnes. 
There was great difficulty in getting the medical units forward 
owing to congestion of roads and the damage to roads by shell- 
fire. Consequently much of the material was brought up on 
pack horses. 

The D.M.S. of the Third Army had estimated that the 
greatest number of casualties would be on the XVI I th Corps 
front, as it was much exposed to enemy fire, and provision had 
been made, especially by the A. D.M.S. of the 34th Division, 
for constructing regimental aid posts in dugouts according to a 
standard plan (see plan). The greater part of the Third Army 
front, however, north of the Scarpe was taken over by the 
XHIth Corps of the First Army after the 12th April. 

On the 30th April the A.D.M.S. of the 9th Division (Colonel 
F. A. Symons) was killed when walking to his advanced dress- 
ing station at St. Nicolas. The division had other heavy 



94 



MEDICAL HISTORY OF THE WAR 



losses in its medical personnel, the medical officer of the 11th 
Royal Scots, Captain T. W. Martin, and an officer of the 
South African Medical Corps, Captain I. Welsh, and three other 
ranks of the R.A.M.C. being killed en the 9th April; while 
eight of the R.A.M.C. and four of the S.A.M.C, were wounded. 
Notwithstanding the difficulties and dangers of this front 
the general scheme for collecting and evacuating the wounded 
to Haute Avesnes and thence to Aubigny worked smoothly 





* $1 




c| 




"*$t 


kJkf/^k 


HA 




■1 . i \ 




*'"''' ''' ■ - ~^''V 



The advanced dressing station at St. Nicolas 
on the road to Roclincourt. 

and well. It was more complicated than that of the 
other corps of the Third Army, in consequence of the use 
of pontoons and tramlines, and the difficulties of bringing 
ambulance transport and material up through the congested 
and broken roads of the Scarpe valley. 

Weather. 
The weather during the earlier days and some of the later 
days of the battle was characterized by high winds, snow, 
sleet and rain. Fortunately the means of shelter and the 
accommodation for the wounded proved ample. 



CHAPTER V. 

THE BATTLE OF VIMY RIDGE. 

THE operations leading to the capture of Vimy Ridge and 
an advance eastward of it were carried out from the 
9th April onwards by the First Army at the same time as the 
Battle of Arras was being fought by the Third Army on its 
right ; but only a portion of the First Army was engaged, and 
consequently the number of casualties was not expected to be 
so great as on the Arras front. 




Cars coming from Lille Road collecting post during the 
Battle of Vimy Ridge. 

For some time before the attack the D.M.S., Surgeon-General 
W. W. Pike, had been preparing for the battle in association 
with Colonel Ross, the D.D.M.S. of the Canadian Corps, which, 
with a brigade of the 5th Division, was to make the attack 
on the 9th April. He had estimated the probable number of 
casualties at 20,000 during the first three days and 10,000 
during the following week. 

The Medical Services with the Canadian Corps. 

The regimental aid posts were in dugouts, and these had 
been enlarged in many instances and greatly improved. The 
trenches leading from most of them were widened to facilitate 



96 



MEDICAL HISTORY OF THE WAR 



stretcher carriage, and arrangements were made to have 
certain trenches allotted for the use of the wounded only. 
Relay posts, along the line of hand carriage, were organized 
back to the advanced dressing stations. 

The advanced dressing stations were, as a rule, in deep 
dugouts protected by steel or iron framework covered with 
sand-bags or earth to a depth of several feet, constructed so as 
to give good cover to the wounded and shelter for the R.A.M.C. 




Roclincourt collecting post, showing snow 
during the Battle of Vimy Ridge. 



personnel. On the average each advanced dressing station 
could take about thirty or forty lying down cases. Other 
dressing stations were organized in cellars and basements of 
breweries, some of which had shelter for 100 or more. 

Evacuation to advanced dressing stations was in some 
sectors by stretchers on trollies, and in a few cases by the horsed 
ambulance wagons. 

Four main dressing stations were prepared behind the front 
of the attack, one at Ecoivres, another at Les Quatre Vents, 
a third at Estree-Cauchie for sick only, and a fourth at Grand 



THE BATTLE OF VIMY RIDGE 



97 



Servins. The main dressing station at Les Quatre Vents was 
organized with three or four tent divisions of Canadian field 
ambulances as a large corps main dressing station. It was 
capable of taking about 2,000 wounded at one time, the 
accommodation having been increased by forty marquees 
before the battle. 

In addition to these main dressing stations, two large collect- 
ing stations for walking wounded were prepared, one at 



-Apr*//- 



Battle of Vimy Ridge. 

Canadian Corps Front. 



-/9/7- 




_ .'' ^RocUMCOur v T, 



+ &£<s*fArn-.AtoPt»T. QAov. Dressing Stat/ on. £U*/aj-kjn6 Wqvho£0 Coj-i-£crriHoSTA-r/QN. 
S3 Ma/h D/zESS/na Stat/oh. » » < ■ « Ra/lmay. — • — • — « — • 7£^w«^v oe ljg/st m^iltjay. 
—~—3*VT/SHf r /zoM7-L/M£.A*>*8' r .'' Scale of yards. 



Villers-au-Bois, and the other at Chateau-de-la-Haie. The 
walking wounded were brought thence by lorries to Hersin 
and Coupigny, where they were retained and taken care of by 
No. 13 Canadian Field Ambulance until they could be evacuated. 
Roads and paths were flagged and arrow indicators placed 
along them to guide the walking wounded to these collecting 
posts, and also to the routes of lorries returning empty to 
railheads. All these positions were in the Canadian Corps 
area until the XHIth Corps took over the right of the Canadian 
Corps on the 12th April. The dressing station at Ecoivres 
then came into the XII Ith Corps area, wounded being evacuated 



9S 



MEDICAL HISTORY OF THE WAR 




"Z ** 

bc-S 
• S> 

-^ 

<U N 

as 

^« 

<u <; 

O 4J 

S§ 




en .5 

.5-° 



THE BATTLE OF VIMY RIDGE 



99 



from it to No. 1 Canadian and No. 24 Casualty Clearing Stations 
at Aubigny. 

The medical situation in the Canadian Corps is shown on the 
map. The chief feature in the Canadian Corps arrangements 
was the use of tram lines for clearing from the regimental aid 
posts to the advanced dressing stations and still farther back. 
All these arrangements had been very carefully and elaborately 
organized. 

The D.D.M.S. of the Corps had his headquarters at Les 
Ouatre Vents. The 1st Canadian Division was on the right 
with its A.D.M.S., Colonel Ford, at Ecoivres. It had two 
advanced dressing stations, one at La Maison Blanche on the 
Arras-Bethune road, south-west of Neuville St. Vaast, and the 
other at Ariane at the cross-roads about one kilometre farther 
south. The 2nd Canadian Division was on the right centre of 
the attack with its A.D.M.S., Colonel Jacques, at Chateau d'Acq. 
The advanced dressing station was at Aux Rietz. The 3rd 
Canadian Division on the left centre had its A. D. M.S., Colonel 
Snell, at Villers-au-Bois, and an advanced dressing station at 
Neuville St. Vaast ; while the 4th Canadian Division on the left 
of the attack had advanced dressing stations along thei\rras road 
just south of Souchez, its A.D.M.S., Colonel Chisholm, being 
at the Chateau-de-la-Haie. 

A tramway line ran from Neuville St. Vaast to Aux Rietz, 
and from there a light field railway went to what was known as 
" Ambulance Corner," just south of Mont St. Eloy, where the 
field ambulance cars were drawn up. As the road north of 
Souchez was impassable the principal route of evacuation to 
the main dressing stations was through Ambulance Corner and 
Mont St. Eloy. 

The A.Ds.M.S. of the Canadian divisions were each allotted 
100 extra men from the divisional troops to act as stretcher 
bearers and this greatly facilitated clearing the wounded back. 

The number of wounded admitted to the field ambulances 
from the commencement of the battle until the 8th May was 
as follows : — 



Division. 


Officers. 


Other ranks. 


1st Canadian Division 

2nd „ 

3rd „ „ 

4th „ „ 

5th Division 
Corps Troops 


147 
110 

82 

119 

53 

10 


3,926 
2,808 
2,166 
2,659 
1,415 
278 


Total 


521 


13,252 



100 



MEDICAL HISTORY OF THE WAR 





THE BATTLE OF VIMY RIDGE 



101 



The majority of the walking wounded went to Coupigny and 
Hersin, and the lying-down cases to Les Quatre Vents, whence 
they were taken to the casualty clearing stations on the north 
side of the Notre Dame de Lorette ridge and the back area. 



The Medical Services with the Xlllth Corps. 



Battle of Vimy Ridge. 



6 ~ 1000 2000 

Scale of yards. 



x*""/-.£!!i Corps Front, -t&r- 

4> Rs&.Aio oa. Coi-i-£c-r/Mo Post. 

ft Adv Daz&ssihg Station. 

A Walking Woumged CouLSCT./hsz 




At the beginning of April the Xlllth Corps had been in the 
First Army reserve with the 2nd, 31st and 63rd (R.N.) Divisions 
in back areas in the neighbourhood of Pernes, St. Venant and 
Busnes. It then moved to the right of the Canadian Corps and 
took over the front line between the Scarpe and Vimy Ridge 
on the 12th April, the medical units of the 2nd and 63rd 
Divisions occupying posts previously held by divisions of the 
XVIIth and Canadian Corps. A section of No. 14 M.A.C. 
was placed at the disposal of its D.D.M.S., Colonel G. Cree, 
at that time, and when the Corps was engaged in severe 
operations against Oppy Wood on the 28th April, the whole 
of this convoy was attached to it. No. 14 M.A.C. was then 
stationed at Ste. Catherine. 

The casualties of the Xlllth Corps were light, and there was 
no special feature or difficulty in the evacuation of the wounded. 



102 



MEDICAL HISTORY OF THE WAR 



The general arrangements of the medical situation during 
this attack on Oppy Wood are shown in the following plan. 

n — ._ Battle ofVimv Ridge. 

diagram ofAULCorps Evacuation Organization April 1917. 



/iEGtMSNTAi- A/D fhST3 







Lr//VQ <£. S/TTIH& h/oc/A/OEC? • 



AuBIGNY. 



.»• Sjck 



The Medical Services with the 1st Corps, 

The 1st Corps was on the left of the Canadian Corps supporting 
the Canadian attack by pressure against Lens. The main 
dressing stations of the corps were in schools at Fosse 10 (Petit 
vSains), Noeux-les-Mines, Bracquemont, Labourse and Bethune. 
The arrangements generally were similar to those in the 
Canadian Corps area, except that the trolly system of eva- 
cuation was not so well developed. 

The D.M.S. had arranged with the D.D.M.S. of the 1st Corps, 
Colonel Westcott, to prepare a large walking wounded collecting 
station with No. 73 Field Ambulance at Bracquemont capable 
of accommodating 1,500 wounded at a time, near the railway 
station there, and for temporary ambulance trains to run to it. 



THE BATTLE OF VIMY RIDGE 



103 




60 U 

■Bgc 

,Q £ a> 



S3 Sg 

O g>« 

O'-g ^ 

Mai 

<1 8^ 



TO -f- 1 -*-> 

^ '3 




o to 

CD TT 



>» 



§p5 




> g 
■sg 

a; ^ 



a3 o 

rt to 

o to 2 

^ O JH 



i^§ 



a£ 



OJ to 

Si 



104 



MEDICAL HISTORY OF THE WAR 



There is no record, however, of its having been necessary to 
bring ambulance trains up to this position. 

In addition to these dressing stations for wounded, large 
rest stations were available for the sick in the Canadian Corps 
area at Fresnicourt, and in the 1st Corps area at Fouquieres and 
Labeuvriere. 




Bearers preparing the~ground for shelters at a 
dressing station at Anzin. 

The two divisions of the 1st Corps specially engaged in the 
Vimy Ridge battle were the 46th and the 6th. They attacked 
in the direction of Lens from Lievin and Loos on the 23rd and 
24th April. 

The A.D.M.S. of the 46th Division, Colonel W. Beevor, had 
special difficulty in getting the wounded away during the day- 
time on account of the enemy's artillery barrage along the lines 
of evacuation, and many severely wounded had to be detained 
by him in large cellars in Lievin during the day. In fact all 
roads leading out of this suburb of Lens were extremely 
dangerous. The nearest advanced dressing station for stretcher 
cases of the 46th division was at the Cite Calonne, between 



THE BATTLE OF VIMY RIDGE 



105 



Lievin and Grenay, with a main dressing station in a school at 
Fosse 10 (Petit Sains), and a walking wounded collecting post 
at Bully-Grenay, and also at Aix-Noulette. 

The 6th Division medical posts were in and around Loos, 
with advanced dressing stations at Maroc and Philosophe, and a 
main dressing station at the Ecole Jules Ferry in Bethune. Its 
walking wounded collecting station was at Mazingarbe. 




Dressing station built into a bank and protected by sandbags at Anzin. 

The following sketch map shows the positions of the medical 
posts in the front area of this division. 



Battle of Vimv Ridge. 
Apt*;/- | sj Corps Front. -^/7- 



^^ WaJ-KJNG h/cKJNOBD COL-L.. FbSTT. 




106 MEDICAL HISTORY OF THE WAR 

The Casualty Clearing Stations. 

With the exception of those at Barlin and Bruay, the sites of 
casualty clearing stations in the First Army were much the same 
as during the battle of Loos, namely, at Merville and St. Venant 
in the northern area, and at Bethune, Chocques, Lapugnoy, 
Lozinghem and Lillers in the southern area. Fort Gassion, 
at Aire, had been taken over by No. 39 Stationary Hospital. 
No. 22 CCS. had been moved from Aire to Bruay, and No. 6 
from Lillers to Barlin, while No. 7 was transferred from Merville 
and opened in Bracquemont, the southern suburb of Noeux- 
les-Mines, on the 21st April, in the hope that the road from 
Souchez would be open then. 

The casualty clearing stations had their accommodation 
largely increased by tents, marquees and huts, and were 
organized in separate sections for the reception of light and 
severe cases respectively. Wounded from the right of the 
attack were to be received in rotation by Nos. 6, 23, 18 and 22 
Casualty Clearing Stations at Barlin, Lozinghem, Lapugnoy 
and Bruay, and those on the left of the attack by Nos. 33, 58 
and 1, at Bethune, Lillers and Chocques, 300 being taken to 
each casualty clearing station in turn, with the exception of 
No. 6 at Barlin and No. 33 at Bethune, which had to take in 
severe cases for early operation at all times and which con- 
sequently were only to receive from the convoys 250 at a time 
These numbers, however, were subsequently found to be too 
many, and were altered to 200 in the case of the casualty 
clearing stations farther back, and 100 to 150 in the case of 
No. 6 and No. 33. 

Day and night signals were prepared at certain cross roads as 
a guide to the returning ambulance cars, indicating which of 
the casualty clearing stations was receiving. Indicators were 
also placed warning the cars of holes in the roads and other 
obstructions. 

The seven casualty clearing stations receiving wounded from 
the front of the attack were reinforced each by a surgical team 
from the Fourth Army and from other casualty clearing 
stations of the First Army, in addition to a team from a field 
ambulance of each division of the First Army, consisting of 1 
medical officer, 2 N.COs. and 8 other ranks. Emergency 
stretcher bearers and others were obtained from the L. of C 
and army troops. In this way the casualty clearing stations 
that were receiving the wounded were reinforced by 41 medical 
officers and 41 nursing sisters, of whom 14 of the former 
and 34 of the latter came from outside the First Army. The 



THE BATTLE OF VIMY RIDGE 



107 



reinforcements of other ranks of the R.A.M.C. were 29 N.C.Os. 
and 128 other ranks, of whom only 7 were from outside the 
First Army. Fifty-nine emergency stretcher bearers were 
obtained from the L. of C. and 130 additional stretcher bearers 
from the First Army troops. 

Each casualty clearing station had from 100 to 150 beds 
prepared on the same scale of equipment and comfort as beds 
in a general hospital for the severer class of cases whom it 
might be necessary to retain for several days before evacuation 
to the base. 




West Riding, No. 58, Casualty Clearing Station at Lillers. 

The Motor Ambulance Convoys. 
The motor ambulance convoys in the First Army at the time 
were Nos. 2, 8, 12 and 13. No. 2, however, was employed in 
the northern area and for entraining duties at Merville, St. 
Venant and Aire. Of the remaining three convoys the D.M.S. 
concentrated two of them, No. 13 and No. 8, at Barlin and 
Labuissiere for clearing the Canadian Corps main dressing 
stations, and No. 12 at Chocques for clearing the 1st Corps. 



108 MEDICAL HISTORY OF THE WAR 

He formed two reserve convoys of eighteen cars each from field 
ambulance cars of divisions of corps not engaged. These 
reserve convoys were parked in their corps areas ready to 
move at an hour's notice. The convoys were supplemented 
by lorries and motor buses, but the D.M.S. found the latter 
unsuitable on account of roads and weather and made very 
little use of them. No. 14 M.A.C. was transferred tem- 
porarily from the Second Army and was at first concentrated 
with No. 13 Convoy at Barlin. The Second Army also sent 
ambulance cars on the 11th April from No. 5 M.A.C, but these 
were returned a few days later. 

The D.M.S. of the Army kept the convoys under his direct 
control, as had been the custom in the First Army, but after 
the capture of Vimy Ridge and when the Xlllth Corps took 
over the right of the First Army, a section of No. 14 M.A.C. 
was placed at the disposal of its D. D.M.S., and eventually the 
whole of the convoy was placed under his control on the 26th 
April. At the same time No. 31 M.A.C. was attached to the 
Canadian Corps until the 26th April, when two of its sections 
were withdrawn to work with No. 8 M.A.C. 

The main dressing stations were all on the southern part of 
the Notre Dame de Lorette ridge which ran east and west from 
Souchez and Mont St. Eloy to the Bruay-St. Pol road with a 
steep descent to the Flanders plain on its northern side. Con- 
sequently the motor ambulance convoys had to cross this ridge 
and descend by steep roads to Barlin and the other casualty 
clearing stations. The route selected was by way of Verdrel, a 
better and shorter route by way of Hersin being considered 
unsafe owing to hostile artillery fire. The direct road through 
Souchez was impassable. 

Evacuation of Casualties. 

The arrangement for ambulance trains was to garage five 
ambulance trains and two tempoiary ambulance trains daily 
in the army area, and to run the temporary ambulance trains to 
Hersin for evacuating the walking wounded collected there and 
at Coupigny. 

The whole of the arrangements worked smoothly and well, 
and there was never at any time congestion in the area. The 
number of casualties in the first forty-eight hours was very 
much less than was anticipated, the admissions to the field 
ambulances up to 9 a.m. on the 11th April being 798 sick and 
6,570 wounded. During that period ^1,032 sick and 5,912 
wounded were evacuated from the army area by nine 



THE BATTLE OF VIMY RIDGE 109 

ambulance trains and three temporary ambulance trains, 
the latter taking away 2,486 from Coupigny alone. There were 
then left in the army area in field ambulances and clearing 
stations only 1,126 wounded and 1,686 sick. A few of the sick 
and wounded were also evacuated from the army area by 
ambulance cars, lorries, buses and barges to St. Omer, but the 
numbers were extremely small, only 15 wounded going back by 
ambulance car, 151 sick and 2 wounded by lorries, 96 wounded 
in buses, and 60 in barges.* 

In the twenty-four hours from 9 a.m. on the 11th to 9 a.m. on 
the 12th April only 802 wounded were admitted to the field 
ambulances, and from that date to the morning of the 23rd 
April, during a period of comparative quiet, the number 
of wounded was 5,053, including 217 officers. The total 
number of wounded from 9 a.m. on the 9th April to 9 a.m. on 
the 23rd April amounted to 12,425, including 433 officers. 
The number of sick admitted during the same period was 8,145, 
including 291 officers. 

During this period of comparative quiet, f constant work was 
carried on in improving the roads and in arranging for the use 
of trollies on tram lines. 

On the 23rd April there was severe righting in the 1st Corps 
from the direction of Lievin and Loos, and in the XHIth Corps 
against Gavrelle, the number of wounded received during the 
twenty-four houis from the commencement of the attack being 
96 officers and 1,711 other ianks. The fighting continued 
during the subsequent four days, but the casualties were then 
comparatively few, the total number of wounded admitted 
from 9 a.m. on the 23rd April to 9 a.m. on the 28th April being 
181 officers and 3,323 other ranks. 

The casualties amongst the medical services were severe. 
Between 9th April and 8th May the losses in the R.A.M.C, 

* Nos. 2 and 5 Ambulance Flotillas were mobilized in anticipation of the 
battle. They had been demobilized during the winter months, when there 
was little fighting in the army area. The barges were being run in pairs, 
with one tug to two barges, but this was found unsatisfactory as if there was 
any wind they could not be steered properly. There was also the disadvantage 
of its being necessary to retain them at the loading point until 60 severe lying 
down cases suitable for conveyance by barge were waiting transfer irom the 
casualty clearing stations. The D.M.S., therefore, arranged with the officer 
in charge of the flotillas at St. Omer to send up barges singly with as many 
tugs as he had for the purpose, and, although he had only six tugs available, 
the work was afterwards done better and cases were sent down more 
expeditiously than when the barges worked in pairs. 

t Bethune was twice shelled during this time. On each occasion the 
patients in No. 33 CCS. were placed in cellars, and no casualties occurred. 



110 



MEDICAL HISTORY OF THE WAR 



Canadian and 63rd (R.N.) Division medical services were as 
follows : — 





Killed. 


Wounded. 


Died of 
Wounds. 


Total. 




Off. 


O.R. 


Off. 


O.R. 


Off. 


O.R. 


Off. 


O.R. 


R.A.M.C. 
C.A.M.C. 

Royal Navy 


5 


14 

10 

7 


4 
5 


72 
78 
34 


— 


3 


9 
5 


89 
88 
41 


Total 


5 


31 


9 


184 


— 


3 


14 


218 



It is of interest to note the number of wounded during the 
first five days of the battles of Arras and Vimy Ridge in the 
First and Third Armies, for comparison with the estimates made 
in preparation for them. The actual numbers, day by day, 
from 9 a.m. on the 9th April to the evening of the 13th April, 
as reported to the D.G.M.S., G.H.Q. were as follows : — 

First Army. 





Officers. 


Other 
ranks. 


Germans. 


9 a.m. 9th to 9 a.m. 10th 

9 a.m. 10th to 9 a.m. 1 1th 

9 a.m. 11th to 5 p.m. 11th 

5 p.m. 11th to 9 a.m. 12th 

9 a.m. 12th to 5 p.m. 12th 

5 p.m. 12th to 9 a.m. 13th 

9 a.m. 13th to 5 p.m. 13th 


113 

72 
15 

9 
22 
19 

8 


2,518 
3,867 
298 
452 
432 
364 
299 


158 

404 

7 

14 

31 

11 

6 


Totals from 9 a.m. 9th to 5 p.m. 13th. . 


258 


8,230 


631 



Total 



8.488 



THE BATTLE OF VIMY RIDGE 

Third Army. 



Ill 





Officers. 


Other 
ranks. 


Germans. 


6 a.m. 9th to 6 a.m. 10th 

6 a.m. 10th to 6 p.m. 10th 

6 p.m. 10th to 6 a.m. 11th 

6 a.m. 11th to 6 a.m. 12th 

6 a.m. 12th to 6 p.m. 12th 

6 p.m. 12th to 6 a.m. 13th 

6 a.m. 13th to 6 p.m. 13th 


445 
75 
71 

168 
31 
42 
44 


9,719 
1,934 

466 
3,753 

638 
1,394 

590 


355 

246 

273 

460 

23 

13 

6 


Totals from 6 a.m. 9th to 6 p.m. 13th. . 


876 


18,494 


1,376 



Total 



19,370 



The total in the two Armies, therefore, was 27,858. The 
D.G.M.S. estimate of ambulance train requirements during the 
first five days was approximately for 37,000 wounded, so that 
there was a good margin of safety in the preparations, although 
this margin would probably have been much less had the 
retreat to the Hindenburg line not taken place before the 
battles. 

The wounded collected during the first seven days, i.e., to 
9 a.m. on the 16th April, were, in the Third Army, 1,040 officers, 
22,795 other ranks, and 1,108 Germans ; and in the First Army, 
294 officers, 8,867 other ranks, and 620 Germans, or a total 
approximately of 34,700, as compared with the preparatory 
estimate for the first seven days of 44,000. 

The activities on the Arras and Vimy front died down during 
May, although considerable pressure was maintained against 
the whole of the enemy's line from Lens southwards. The 
Third Army was then beginning to extend its front to the Somme 
in order to set free the Fifth Army for active operations in the 
Ypres Salient. 



CHAPTER VI. 

THE FLANDERS OFFENSIVES IN 1917. 

THE offensive operations in Flanders, which were to take 
place after the battles of Arras and Vimy Ridge, com- 
menced in June with the attack on and capture of the whole 
of the Messines-Wytschaete ridge and the advance of the 
British line a distance of 2J miles in the centre of the attack, 
to a new line southwards through Klein Zillebeke from the 
Ypres Salient to the neighbourhood of the Lys west of 
Warneton. 

Changes in Army Areas. 

During the preparations for the main offensive which was to 
follow, the areas and composition of the British armies in France 
and Flanders underwent extensive readjustment. The coast 
area between Dunkirk and Nieuport previously occupied by 
French troops was taken over by the British. The XVth Corps 
was detached from the Fourth Army in June and became an 
independent command directly under G.H.Q. in this area, but 
early in July the Fourth Army headquarters moved to Malo- 
les-Bains, the eastern suburb of Dunkirk, and took over the 
command. 

The Fifth Army headquarters moved to Flanders during the 
second week in June and took over the Ypres Salient from the 
Second Army. 

The Third Army then extended its front southwards by 
taking over the areas previously occupied by the Fourth and 
Fifth Armies. Its front area was thus facing the Hindenburg 
line from Arras to the vicinity of Epehy and Ronssoy, and 
continuous pressure was maintained against this line while the 
preparations for the Flanders offensive were being made. The 
Third Army headquarters moved from St. Pol to Albert. 

The First Army also continued to attack the enemy both 
north and south of Lens and reached the outskirts of that town. 

The Second Army remained in its original area until after 
the Battle of Messines, when, as noted above, its left sectors 
in the Ypres Salient were taken over by the Fifth Army. 



THE FLANDERS OFFENSIVES IN 1917 



113 



The Changes in the Medical Situation of Armies. 

These preparations involved considerable changes in the 
strategical position of the medical units. With the exception 
of the divisional sanitary sections, which remained in sanitary 
areas in accordance with the policy adopted earlier in the year, 
the divisional medical units accompanied their divisions to 
new areas. 

Many of the casualty clearing stations, motor ambulance 
convoys, advanced depots of medical stores, and mobile 
laboratories of the Fourth and Fifth Armies remained where 




Rest area for field ambulance near St. Omer. 



they were when the headquarters of these armies moved to 
Flanders. They came then under the control of the D.M.S. of 
the Third Army. Others were moved to the Ypres and Dunkirk 
areas. 

After these moves had taken place in June and July the 
D.M.S. of the Third Army had eighteen casualty clearing 
stations, including the Indian, at his disposal, situated 
as follows : — 



Lucknow . . 

No. 38 

Nos. 21 and 48 
Nos. 5 and 55 



at Peronne la Chapel-"^ 

lette 
at Bray 
at Ytres 
at Tincourt 



From 
4th Army. 



(10134) 



114 



MEDICAL HISTORY OF THE WAR 



No. 56 

Nos. 45 and 49 
Nos. 3 and 29 
No. 9 

Nos. 20 and 43 
Nos. 30 and 42 
Nos. 19 and 8 



at Edgehill 
at Achiet le Grand 
at Grevillers 
at Aveluy 

at Boisleux au Mont 

at Aubigny 

at Agnez-les-Duisans 



[_ From 
f 5th Army. 



He had also the following stationary hospitals :- 
No. 6 . . . . at Frevent 

No. 12 . . . . at St. Pol 

No. 3 Canadian . . at Doullens Citadel 
No. 41 . . . . at Gailly 




Rest area for field ambulance near St. Omer. 



The casualty clearing stations at Peronne-la-Chapellette, 
Colincamps, Varennes, Warlincourt Halte, Avesnes, Doullens, 
Gezaincourt and Boubers-sur-Canche had been closed, and apart 
from the single units at Bray, Edgehill and Aveluy, and the 
Indian CCS. at Peronne-la-Chapellette, the casualty clearing 
stations were in groups of two at Ytres, Tincourt, Achiet-le- 
Grand, Grevillers, Boisleux au Mont, Agnez-les-Duisans and 
Aubigny. The last group, however, was handed over to the 
First Army towards the end of August, thus reducing the 
number of casualty clearing stations in the Third Army to 
sixteen. 



THE FLANDERS OFFENSIVES IN 1917 115 

Seven motor ambulance convoys were left with the Third 
Army, namely Nos. 3, 15, 16, 30, 21, 27 and 36. Five bacterio- 
logical, three hygiene laboratories, and six advanced depots of 
medical stores also remained with this army. 

There were practically no changes at first in the positions 
of the medical units of the First Army ; but in Septembef 
and October, Surg. -General H. N. Thompson, who had 
succeeded Surg. -General Pike as D.M.S. of the Army in 
July 1917, when the latter was sent on special duty to East 
Africa, commenced moving casualty clearing stations to two 
advanced positions, under canvas, the one at St. Aubin, two 
and a half miles north-west of Arras, and the other in open fields 
on the Ruitz-Houchin road, west of Barlin. The casualty 
clearing stations at Barlin and St. Venant, which had been 
subjected to bombing from the air, were moved to these new 
positions. The Ruitz site was deliberately chosen as being at 
some distance from the railway line and other places likely to be 
shelled or bombed by the enemy. Aire ceased to be a casualty 
clearing station centre in May, when a stationary hospital, 
No. 39, took the place of the casualty clearing station in Fort 
Gassion. 

Up to the time when the Fifth Army took over 
the Ypres Salient, the Second Army medical units were 
unchanged. In preparation for the Battle of Messines the 
D.M.S. , Surg.-General R. Porter, whose headquarters were in 
Hazebrouck, had grouped four casualty clearing stations at 
or near Bailleul (No. 2, and No. 1 Australian in the town, No. 
53 on the northern outskirts, and No. 11 at an ambulance train 
siding on the main line where the railway crossed the Armentieres 
-Bailleul road), four at Remy Siding (Nos. 2 and 3 Canadian, 
No. 10 and No. 17) and two at Mendinghem near Proven (Nos. 
46 and 12). There were single units at Trois Arbres (No. 2 
Australian), Monts des Cats (No. 50), and Hazebrouck (No. 15). 
The motor ambulance convoys with the Second Army were 
No. 4 at Proven, No. 5 and No. 14 at Bailleul (the latter on 
return from the First Army on 20th May), No. 1 1 at Poperinghe, 
and No. 22 at Hazebrouck. The advanced depots of medical 
stores were No. 2, No. 11 and No. 2 Canadian at Bailleul, 
Hazebrouck and Remy Siding respectively, and there were 
three bacteriological and one hygiene laboratory in the army 
at this period. 

After the Messines battle the groups of casualty clearing 
stations at Remy Siding and Mendinghem came under the 
adminstrative control of the Fifth Army. 

(10134) k 



116 MEDICAL HISTORY OF THE WAR 

Owing to severe shelling of Bailleul in July and bombing 
of Hazebrouck in September, casualty clearing stations in these 
towns were closed. Those at Bailleul, except No. 53, which 
remained in the asylum north of the town, were moved to 
Oultersteene, three miles south-west of Bailleul, and to Gode- 
waersvelde, while the casualty clearing stations and stationary 
hospital at Hazebrouck were transferred to Ebblinghem, halfway 
between Hazebrouck and St. Omer. Oultersteene then had 
two casualty clearing stations, No. 2 and No. 1 Australian, and 
Godewaersvelde three, Nos. 11, 41 and 37, the last having 
been transferred in July from Avesnes le Comte in the Third 
Army area. 

The medical preparations which were made for the 
Fifth Army behind Ypres were of an extensive character, 
and every medical unit that could be spared was demanded by 
its D.M.S., Surg.-General Skinner, and sent to him. In addition 
to the groups of four casualty clearing stations at Remy Siding 
and the two at Mendinghem taken over from the Second Army, 
new groups were formed at Brandhoek, Dozinghem and 
Bandaghem in June, after the arrival of the Fifth Army head- 
quarters in the area. 

Dozinghem and Bandaghem were fancy names, similar to 
Mendinghem, given to new sites in open ground near broad 
gauge railway lines ; the former three miles north of Poperinghe 
in a clearing of the woods between Lovie Chateau and the 
convent north-east of it ; and the latter in fields about one 
mile south of Rousbrugge-Haringhe and some six miles north- 
west of Poperinghe. The site for the group at Brandhoek was 
close to the Ypres-Poperinghe main road about two and a half 
miles east of Poperinghe and between the road and the railway 
line. Nos. 4, 47 and 61 Casualty Clearing Stations were trans- 
ferred from Varennes and Edgehill to Dozinghem ; Nos. 62 and 
63 from Doullens and Boubers-sur-Canche to Bandaghem, and 
Nos. 32, 44 and 3 Australian to Brandhoek from Warlincourt, 
Puchevillers and Grevillers respectively. No. 13 CCS. was also 
transferred to the Fifth Army in August, but after being brought 
to Remy Siding and then to Mendinghem was not definitely 
opened until brought to a back area near Arneke four miles 
north-west of Cassel at the end of September. Surg.-General 
Skinner was thus provided with sixteen casualty clearing 
stations. 

He was given five motor ambulance convoys, four being 
transferred to him from other armies, No. 4 at Proven from the 
Second Army, No. 31 and No. 24 from the Third Army, and 



THE FLANDERS OFFENSIVES IN 1917 117 

No. 20 from the Fourth Army. The fifth convoy, No. 6, was 
brought up from Beauval when the Fifth Army moved to 
Flanders. 

Three advanced depots of medical stores were transferred to 
the Fifth Army, No. 2 Canadian at Remy Siding from the 
Second Army ; No. 18 to Dozinghem from the Third Army and 
No. 31 to Proven from the L. of C. No. 19 which had been 
brought up from Peronne-la-Chapellette in July to the Second 
Army and opened at Godewaersvelde was also transferred to the 
Fifth Army in October and placed by the D.M.S. in Poperinghe. 

Three mobile bacteriological laboratories were transferred, 
one each from the Second, Third and Fourth Armies, and a 
newly formed mobile hygiene laboratory, No. 23, was also 
sent to the Fifth Army and placed at Poperinghe. An additional 
mobile bacteriological laboratory, No. 17, was transferred from 
the Second Army in October. 

A number of divisional sanitary sections proportionate to the 
size of the army area and the divisions in it were allotted to 
sanitary areas. Most of these were taken over from the Second 
Army in the areas over which they were carrying on sanitary 
duties at the time the Fifth Army came up to Flanders. 

The Fifth Army was thus exceptionally well provided with 
medical units under the control of the D.M.S. 

When the XVth Corps took over the Dunkirk-Nieuport 
area it had three divisions, the 1st, 32nd and 66th. 
Two casualty clearing stations, No. 1 Canadian and No. 24, 
were then transferred with it from Aubigny, and opened in 
fields near Oosthoek, on the railway line about one mile east 
of Adinkerke; the former unit occupied huts of a voluntary 
hospital, which had been working with the French in that 
locality. The staff of the voluntary hospital followed the French 
troops to Roosbrugge, and were given huts there by the British 
\ in exchange for those left by them at Oosthoek. 

In July two more divisions, the 49th and 33rd, came into the 
area, and three casualty clearing stations, Nos. 36 and 39 from 
Peronne-la-Chapellette, and No. 34 from Tincourt, were then 
transferred to the coast area. No. 39 was added to the group 
at Oosthoek, while Nos. 36 and 34 were opened in part of a 
large modern sanatorium on the shore at Zuydcoote. The 
greater portion of the building continued, however, to be used 
as a hospital by the French Medical Service, which remained 
there after the French troops had left the area. 

The Belgians had a large hospital at La Panne under the 
direction of Dr. Depage, whose surgical work had frequently 



118 MEDICAL HISTORY OF THE WAR 

come under the observation of the British consulting surgeons. 
He had a large staff of nursing sisters, some of whom were 
English, and arrangements were made for the more urgent and 
severe cases of wounds to be sent to this hospital. An officer 
of the R.A.M.C. was attached to it for the purpose of discipline 
and maintenance of records. 

Two motor ambulance convoys, Nos. 26 and 10, a mobile 
bacteriological and a mobile hygiene laboratory, and an advanced 
depot of medical stores, were transferred from the Somme area 
to the coast and distributed to Malo-les-Bains, Zuydcoote and 
Oosthoek. 

Malo-les-Bains, a sea-side suburb east of Dunkirk, was the 
headquarters of the XVth Corps until the Fourth Army Head- 
quarters arrived. The corps headquarters then moved forward 
to Bray Plage. The building at Malo-les-Bains occupied by the 
XVth Corps headquarters office was wrecked on the 27th June 
1917 by a long distance enemy shell, and the headquarters 
had moved to a large hotel on the sands further east. The 
coast area remained under the command of the Fourth 
Army from the 8th July until the 4th November, when the 
XVth Corps was withdrawn, and the area again handed over to 
French troops. 

Outline of the Offensive in Flanders in 1917. 

During the period June to November 1917 the offensive in 
Flanders was carried out in a succession of carefully prepared 
attacks by the Second Army in June against the enemy's 
positions on the Messines-Wytschaete Ridge ; by the Fifth 
Army in association with the French troops at the end of July 
and during August against the positions in the Ypres Salient ; 
by the Second and Fifth Armies in September, and by the 
combined Second, Fifth and French troops in October and 
November until active hostilities ceased in Flanders in the 
middle of the latter month. 

In the Dunkirk area no active offensive was undertaken, 
but preparations were being made, during the time it was occu- 
pied by British troops, for combined operations with the Navy 
on the enemy's flank between Nieuport and Ostend, whenever 
the operations in the Ypres Salient afforded a suitable oppor- 
tunity. 

The Fifth Army headquarters left Flanders for the Somme 
area on the 14th November. The Second Army headquarters 
left at the same time for Italy, and were replaced by the Fourth 



THE FLANDERS OFFENSIVES IN 1917 119 

Army headquarters, the designation of the army in the Ypres 
Salient being changed on 20th December from Second Army 
to Fourth Army. 

The Medical Arrangements. 

The general details of the medical arrangements for these 
battles were similar to those described in the previous battles, 
more especially those of Arras and the Vimy Ridge ; but some 
important new features were introduced. Measures to deal 
with mustard gas, which was used by the enemy for the first 
time, were introduced. Surgical cleansing of wounds before 
evacuation to the base became the established method of 
treatment at casualty clearing stations, and the principle of 
retaining so-called shell shock cases in a casualty clearing 
station especially organized for their treatment in as advanced 
a position as possible was adopted in the Fifth Army. 

These influenced to a very great extent the medical arrange- 
ments before and during the Flanders offensives in 1917 ; and 
it is chiefly in connection with them that the medical work of 
the battles differed from that of the previous battles. 



CHAPTER VII. 



THE BATTLE OF MESSINES. 



THE battle of Messines was fought by the divisions of the 
Ilnd Anzac, the IXth and Xth Corps under the Second 
Army command. It commenced at ten minutes past three on the 
morning of the 7th June without previous bombardment by the 
explosion of nineteen large mines simultaneously beneath the 
enemy's defences followed by an attack by the troops under a 
creeping artillery barrage. The scheme of operations had been 
carefully prepared. One objective line after another was seized 
according to plan, the final objective being reached in the 
evening. The new line was then consolidated and with the 
exception of operations carried on to maintain the line against 
counter attacks the active offensive ceased. 

The General Medical Arrangements. 

The general arrangements for the medical services were 
prepared with the same amount of care and detail as those foi 
the attack. 

The A.Ds.M.S. of divisions were made responsible for clearing 
the wounded from the firing line to the corps main dressing 
stations and corps collecting posts ; the D.Ds.M.S. of corps for 
clearing from these posts to the casualty clearing stations ; 
while the D.M.S. of the army co-ordinated the clearing of the 
casualty clearing stations to the lines of communication. 

Regimental Aid Posts. — With regard to the work of the 
A.Ds.M.S. arrangements in most of the divisions had been made 
for eighty men to be kept as stretcher bearers in reserve at 
the advanced headquarters of each brigade, and supplies of 
stretchers were kept at regimental aid posts for them. Most of 
the regimental aid posts were connected by trench tramways 
with advanced dressing stations, and the majority of the 
wounded were brought down by these. The regimental aid 
posts had been increased in number and size, and strengthened. 

Advanced Dressing Stations. — The majority of the advanced 
dressing stations were situated near a narrow gauge field railway 
which had been constructed along the whole front. 



vMendinghem 
PROVE* 



BATTLE OF MESSINES JUNE 1917. 

GENERAL SITUATION OF MEDICAL UNITS, SECOND ARMY. 



Scale of Miles 
J i 2- 



+ Rea~mntl. Aid Post. Q Advanced Dressing Station or Collecting Post A Walkg. Wnded. Coll. Post. 

Q Main Dressing Station A Cas. Cu 



Motor Amb. Convoy O Adv. Depot Medical Stores. 




ARMENTIERES 



Malby&Sons.Lith. 



THE BATTLE OF MESSINES 121 

The five advanced dressing stations of the Ilnd Anzac Corps 
were, roughly, from 1,700 to 2,700 yards behind the firing line, 
those of the IXth Corps some 1,500 to 2,500 yards, and those 
of the Xth Corps from 2,000 to over 4,000 yards, the farthest 
back being an advanced dressing station at Dickebusch. 

A divisional collecting post of the Xth Corps, which had been 
established mainly for walking cases, was some 6,000 yards 
from the firing line, the walking cases being evacuated to it by 
the narrow gauge railway line. 

Main Dressing Stations. — Two main dressing stations of the 
Ilnd Anzac Corps were respectively some 7,000 and 5,500 
yards behind the firing line. Those of the IXth Corps at 
Dranoutre, Locre and Westoutre, 5,500, 6,000 and 8,000 yards 
respectively, and those of the Xth Corps at La Clytte road and 
Brandhoek, 6,500 and 10,200 yards. All of them were equipped 
with seven special sets for giving oxygen to gassed cases. 

Large numbers of the slighter cases and of the lightly wounded 
were transferred direct from them to divisional rest stations. 

Motor Ambulance Convoys. — A motor ambulance convoy was 
allotted to each of the corps by the D.M.S. for the evacuation 
of the seriously wounded from the main dressing stations to the 
casualty clearing stations. For the conveyance of lightly 
wounded to the casualty clearing stations thirty lorries were 
placed at the disposal of each corps D. D.M.S. 

Casualty Clearing Stations. — The casualty clearing stations to 
which the wounded were evacuated were Nos. 46 and 12 at 
Mendinghem, Nos. 10 and 17 and Nos. 2 and 3 Canadian at 
Remy Siding, Nos 2, 8 and 53 at Bailleul, No. 11 on the railway 
line south of Bailleul, and No. 2 Australian at Trois Arbres, or 
eleven in all ; but the groups of casualty clearing stations at 
Remy Siding and Mendinghem were transferred to the Fifth 
Army at noon on the 10th June, and No. 11 CCS. was closed 
on the 9th June owing to the enemy shelling its position at the 
ambulance train siding with long range high explosive shells. 
During the three days in which it was receiving wounded a 
total of 4,210, chiefly walking wounded, were brought to it. 

Each of the casualty clearing stations had been expanded to 
accommodate 1,000 wounded, and had been reinforced by 
extra personnel two days before the battle. Additional 
operating tables and at least 100 fully equipped hospital beds 
had been provided in each. The additional personnel at each 
of the eleven casualty clearing stations were three surgical 
teams, three additional medical officers, from six to twelve 



122 MEDICAL HISTORY OF THE WAR 

additional nursing sisters, and twenty other ranks of the 
R.A.M.C. The surgical teams were obtained from casualty 
clearing stations of other armies. 

In addition to these eleven casualty clearing stations, the 
Second Army had two casualty clearing stations in back areas, 
No. 50 at Mont des Cats, and No. 15 at Hazebrouck, to which 
sick and wounded could be transferred if necessary. 

A labour company was allotted to act as stretcher bearers 
at the casualty clearing stations, thirty men being distributed 
to each, and thirty to each of the ambulance train sidings. The 
work of loading and unloading patients at the casualty 
clearing stations was mainly carried out by them. 

The general distribution of wounded to casualty clearing 
stations was for the main dressing stations of the northern 
sectors of the Xth Corps to be cleared to Mendinghem, those 
of its southern sector and the northern sector of the IXth Corps 
to Remy siding, those in the southern sector of the IXth Corps 
and northern sector of the Ilnd Anzac Corps to the casualty 
clearing stations at Bailleul, and those in the southern sector of 
the Ilnd Anzac Corps to the Australian casualty clearing station 
at Trois Arbres. Two casualty clearing stations, No. 11 and 
No. 3 (Canadian) were intended to receive walking wounded only. 

Casualty clearing stations, with the exception of those 
set apart for the reception of the lightly wounded, received 
patients in rotation, 150 at a time. This enabled surgical 
operations to be carried out with the least possible delay, 
and in fact during the first three days of the battle as 
many as 2,400 major operations were performed. 

The total number of wounded was considerably less than was 
anticipated, and at no time was there any difficulty in dealing 
with them in the medical units. There were many more in 
the area of the Ilnd Anzac Corps than in the corps farther north. 
They began to arrive very early at Trois Arbres and Bailleul 
casualty clearing stations, in fact, in little over an hour after the 
attack commenced. The evacuation of wounded from the 
regimental aid posts to the corps main dressing stations was thus 
extremely rapid. The chief difficulty was felt at Bailleul where 
the casualty clearing stations were in buildings with narrow 
approaches and situated some distance from each other. 
Owing to the simultaneous arrival of cars bringing wounded and 
cars for evacuating wounded to the ambulance trains in the 
narrow approaches to the casualty clearing stations in the town 
it became necessary to increase the numbers received in rotation 
in the casualty clearing stations at Bailleul to 250 lying down 



THE BATTLE OF MESSINES 123 

cases, so as to give time for evacuation to take place before 
convoys began to arrive with fresh cases. This difficulty at 
Bailleul was consequently only very temporary.* The rapid 
evacuation of wounded to the casualty clearing stations was 
in a measure due to the arrangements which had been made 
before the battle to distribute sterilized dressings in suitable 
sizes to the field ambulances for use at the regimental aid posts 
and dressing stations, thus reducing considerably the time 
taken to prepare wounded for further transport. 

The Ambulance Trains. — During the first three days of the 
battle thirty-five ambulance trains or temporary ambulance 
trains were used. Sixteen trains had been garaged in the army 
area before midnight of the 6th/7th June, and each train as it 
moved up to the casualty clearing stations was replaced by 
another from the garage. On the first day ten ambulance trains 
and two temporary ambulance trains ran from the casualty 
clearing stations to the base ; on the second day twelve 
ambulance trains and three temporary ambulance trains, and 
on the third day eight ambulance trains and no temporary 
ambulance trains. 

The Medical Services with Divisions and Corps. 

The arrangements for the work of the medical services in the 
divisions and corps engaged in the battle were of a very complete 
and methodical character in all. 

Ilnd Anzac Corps. — The advance of the Ilnd Australian and 
N.Z. Corps was against Messines in the southern sector on the 
right of the battle. 

The divisions engaged were the 3rd Australian (A.D.M.S., 
Colonel A. T.White), the New Zealand (A.D.M.S., Colonel D. J. 
McGavin), and the 25th (A.D.M.S., Colonel H. I. Pocock). The 
4th Australian Division (A.D.M.S., Colonel G. W. Barber) was 
in support. It passed through the New Zealand Division and 
25th Division in the afternoon of the 7th June and carried on 
the attack with the 3rd Australian Division. 

The medical arrangements were dominated by the physical 
features of the corps area. A hill, known as Hill 63 just north 
of Ploegsteert Wood, stood out between the right and left 
sectors of the attack. The D.D.M.S., Colonel C. W. Begg, 
N.Z.M.C, consequently organized two lines of evacuation, one 
to the south and one to the north of the hill. 

* A similar difficulty had occurred in the Ypres battles of 1915, when 
special arrangements had also been made to deal with the rapid arrival of 
wounded at Bailleul. 



124 MEDICAL HISTORY OF THE WAR 

A corps main dressing station and a corps walking wounded 
collecting station for the southern area were established at 
Pont d'Achelles, where a road from Ploegsteert joins the main 
road between Armentieres and Bailleul. This served for the 
reception of wounded coming down from advanced dressing 
stations and collecting posts on the south and north-east of 
Ploegsteert Wood. The advanced dressing stations were at the 
Brewery south of Ploegsteert, and at points known as Charing 
Cross and Underhill Farm, with collecting posts for walking 
wounded at Touquet Berthe and Hyde Park, the latter between 
the Brewery and Charing Cross, and the former east of Underhill 
Farm. A narrow gauge railway had been constructed in a circuit 
running near these posts and leading through Romarin to a 
railhead, called the Duke of Connaught railhead, about 1,000 
yards north of Pont d'Achelles. The walking wounded were 
brought down to the railhead on trollies and from there went 
on foot to the dressing station. 

From Pont d'Achelles the wounded on stretchers were 
evacuated by motor ambulance convoy to No. 2 Australian 
CCS. at Trois Arbres, about one mile south-west of Pont 
d'Achelles. The slighter cases of wounds and sickness went to 
divisional rest stations, formed by field ambulances at Steen- 
werck and L'Estrade, about one mile south-east of Steenwerck, 
or to No. 11 CCS. at the ambulance train siding south of 
Bailleul. 

North of Hill 63 in the sectors from which the New Zealand 
and 25th Division made the attack, sites for a corps main 
dressing station and walking wounded collecting station were 
prepared near Westhof Farm, one mile south-west of Neuve 
Eglise. They received the wounded from advanced dressing 
stations at Kandahar Farm on the Neuve Eglise-Wulverghem 
road and at Lindenhoek road one mile north of Neuve Eglise ; 
and from collecting posts, Leinster House and Leeuwerck 
Farm, south-east and east of Neuve Eglise. This area was hilly 
and consequently narrow and broad gauge railways did not run 
into it to the same extent as in the southern area, but tram lines 
were run from the trenches to the advanced dressing stations. 

Wounded were taken by convoys to the casualty clearing 
stations in Bailleul. 

Divisional rest stations for the New Zealand and 25th Division 
were at Ravelsberg, about two miles east of Bailleul on the 
Neuve Eglise road and in Bailleul. 

Personnel for the corps main dressing stations and corps 
collecting stations consisted of a tent subdivision from each of 



THE BATTLE OF MESSINES 125 

the field ambulances of the divisions engaged. Each of the field 
ambulances of the two Australian divisions provided the sub- 
divisions for the Pont d'Achelles dressing and collecting 
stations. They were placed under the command of Lieut. - 
Colonel F. A. Maguire of No. 9 Australian Field Ambulance. 
At Westhof the field ambulances of the New Zealand and 25th 
Divisions supplied the six tent sub-divisions, under the com- 
mand of Lieut. -Colonel H. B. Kelly of No. 77 Field Ambulance. 
By this arrangement the divisions retained all their field 
ambulances as mobile units. A tent sub-division of No. 4 
New Zealand Field Ambulance was also detailed to detrain 
patients at the Duke of Connaught railhead and conduct them to 
Pont d'Achelles ; and a medical officer of the Australian Army 
Medical Corps was detailed to act as medical railway transport 
officer and supervise generally the entraining and detraining of 
wounded at the various points on the narrow gauge line. 

Colonel McGavin of the New Zealand Division was placed in 
charge of the general arrangements for clearing wounded to the 
main dressing station. 

The following clear and precise orders were issued by the 
corps. They are a good example of orders for the medical 
arrangements during a battle. These orders were adhered to 
with very minor alterations. 

" Ilnd Anzac Corps Medical Arrangements. 
Battle of Messines. 

In the proposed scheme, the principle of working with one corps main 
dressing station has had to be modified by the fact that the area is 
divided by Hill 63 into two approximately equal parts. In order to 
fall in with the general scheme of traffic control, it is necessary to 
establish two corps main dressing stations. One of these will deal with 
cases from the north, the other from the south of Hill 63. 

Similarly, the line of evacuation from the north area will be to casualty 
clearing stations in Bailleul, while from the south cases will go to Trois 
Arbres. 

Medical personnel available : — 
12 Field Ambulances. 

1 Motor Ambulance Convoy. 
All available P.B. men. 

CCS. — The scheme is based on casualty clearing stations at Trois 
Arbres and at Bailleul, with special accommodation for walking cases 
at both places. Certain casualty clearing stations will be set apart for 
special cases. 

Stretcher Cases. — Responsibility for the conveyance of wounded to the 
regimental aid posts rests with battalions and brigades. The arrange- 
ments necessary for reinforcing the small stretcher bearer establishment 
should be made before the action. Medical personnel from field ambu- 
lances should on no account be used for this purpose. 

A.D.S. — Field ambulances take over cases at the regimental aid posts 
and convey them by hand carriage, wheeled stretchers, etc., to advanced 
dressing stations. Trench tramways should be made use of, and special 



126 



MEDICAL HISTORY OF THE WAR 



" gates " for carrying five stretchers on a truck should be ready. Arrange- 
ments must be made with the tramway operating staff to assist in every 
possible way. 

C.M.D.S. — From the advanced dressing stations cases are conveyed 
by divisional motor and horse ambulances to the corps main dressing 
stations, where divisional responsibility ceases. 

Walking Cases. — Special provision must be made for walking cases. 
They must on no account be allowed to enter the advanced dressing 
stations. Divisional collecting stations should be formed at convenient 
places not in the vicinity of an advanced dressing station. There walking 
cases should be fed, dressed if necessary, and sent on by returning 
empty transport, 60 cm. railway and lorries, if available. The 
routes for walking cases should be well marked by notices, and by lights 
at night, showing the way to the corps collecting station. 

Records. — All records will be kept at the corps main dressing stations 
and at the corps collecting stations. Serum. — Anti-tetanic serum will 
also only be administered at these stations. 

Evacuation of sick and wounded. — 

For this purpose the corps sector is divided into two sub-sectors — 

1. South of Hill 63 — from the River Lys to the Douve. 

2. North of Hill 63 — from the Douve to the North of sector. 
Sub-sector 1. 



Corps main dressing station 
Advanced dressing stations 



Regimental aid posts 



Pont d'Achelles B.8.b.3.5. * 
Brewery C.l.d.4.5. 

Charing Cross U.19.d.l.5. 
Underhill Farm T.18.C.5.3. 
C.9.d.4.2. 
C.3.C.8.3. 
U.21.a.2.8. 
U.14.d.8.7. 
U.14.d.3.7. 
U.14.a.6.8. 
Corps main dressing station will accommodate 600 stretcher cases. 
Corps collecting station will accommodate 700 walking cases. 
The personnel required for these stations will be six complete tent 
sub-divisions, which will be supplied by the divisions evacuating to these 
stations. 

Sick. — The divisional rest station at L'Estrade will be used as a corps 
hospital for the sick of two divisions. One tent sub-division will be 
sufficient for this work. 

Trivial wounds. Shell-shock. — The divisional rest station at Steen- 
werck will be used as a corps hospital for very slight wounds and " shell- 
shock " cases. 

Walking cases. — Divisional collecting posts for these will be established 
at Touquet Berthe, U. 26. a. 2.1, and in the vicinity of Catacombs. These 
posts will be evacuated to the corps collecting station at Pont d'Achelles. 
B.8.b.3.5. 



Sub-sector 2. 

Corps main dressing station . 
Advanced dressing stations . 

Regimental aid posts . . 



T.19.b.4.5. 

Kandahar Farm T.10.b.7.7. 
Lindenhoek Road T.3.a.0.4. 
Spring Street U.7.b.3.5. 

Fort Osborne U. I.e. 3. 4. 

Boyle's Farm U.l.a.4.0. 

Pont de St. Quentin T.6.C.1 
Shamus N.35.d.6.0. 



* These map references are as they appear in the orders. They indicate 
the exact position in the squared maps of the 1 in 40,000 scale. 



THE BATTLE OF MESSINES 127 

Walking Cases. — Divisional collecting posts for these will be established 
at Leeuwerck Farm, T.10.d.4.2 and White House, T.10 central. These 
posts will be evacuated to the corps collecting station at T.19.b.4.5. 

Corps main dressing station will accommodate 600 stretcher cases. 

Corps collecting station will accommodate 700 walking cases. 

The personnel required for these corps stations will be six complete 
tent sub-divisions, which will be supplied by the divisions evacuating to 
these stations. 

Sick — The divisional rest station at S.16.C.3.2. will be used as a corps 
hospital for the sick of two divisions. One tent sub-division will be 
sufficient for the work. 

Trivial wounds. Shell-shock. — The divisional rest station at Bailleul 
will be used as a corps hospital for very slight wounds and " shell-shock " 
cases. This and the similar station for the southern area, will each 
require one complete tent sub-division. 

Reserve of ambulances. — A pool of ambulance cars from the division in 
reserve will be formed, and these will be available, on application from 
an A.D.M.S. to the D.D.M.S., to assist at any point where the casualties 
have been particularly heavy. 

M.A.C. — The O.C., M.A.C., will be responsible for the evacuation of 
cases from the corps main dressing stations and the corps collecting 
stations to the casualty clearing stations at Trois Arbres and Bailleul, 
and to the various corps hospitals. In the case of slightly wounded men 
(walking cases), he will arrange to make full use of returning motor 
lorries and other transport. He will set apart a few cars for the con- 
veyance of special cases (such as head and abdominal) to special operating 
centres. 

Spare stretchers and blankets. — At each main dressing and collecting 
station a N.C.O. will be detailed to see that every ambulance, on unloading, 
is supplied with its full complement of stretchers and blankets. In 
addition to the usual supply of 150 stretchers and 400 blankets per 
ambulance a large number will be kept at the main dressing and collecting 
stations. It will be the duty of the O.C., M.A.C, to ensure that this 
supply is maintained. 

The primary principles for successful evacuation are : — 

Stretcher cases : — 

1. Regimental aid posts prepared far forward, but not occupied till 

the troops are about to advance, to save stretcher bearers. 

2. Route of evacuation to advanced dressing stations, which should 

be at the most advanced point to which ambulances can be 
brought, at right angles backward from the line of advance, 
to save field ambulance bearers. 

3. Route of evacuation from advanced dressing stations to be the 

shortest possible road to main dressing stations to save divisional 
ambulance transport. 

4. The formation of corps main dressing stations and corps collecting 

stations to save motor ambulance convoy cars. 

Walking cases : — 

1. Clearly marked routes to divisional collecting posts. These posts 

should not be near advanced dressing stations. 

2. Collecting posts, where walking cases can be fed, dressed if 

necessary, and loaded on returning transport. 

Note. — Returning empty railway stock will be available for the 
conveyance of wounded subject to the proviso that the stock is not 
deflected from its route. 

A halt of five minutes can be arranged for the clearance of the 
wounded." 



128 MEDICAL HISTORY OF THE WAR 

The A. D. M.S. of the 25th Division, whose line of advance was 
on the north of the Neuve Eglise-Messines road, had organized 
a scheme of collecting wounded by battalions, which departed 
from the normal system. In consequence of the narrowness 
of the front the battalions were to advance by " leap-frogging," 
that is, after one battalion had gone a certain distance, another 
fresh one was to pass through it and go on. Regimental medical 
officers at a conference with the A.D.M.S. agreed that the 
stretcher bearers of the battalion in front should carry back 
wounded to the headquarters of the battalion next behind and 
then return to their own aid post. The bearers of the battalion 
leap-frogging to the next position were then to carry back to 
the original British front line trench and so on in succession. 

This arrangement meant a series of relay posts, worked by 
battalion, instead of by field ambulance stretcher bearers. It 
was said on the whole to work satisfactorily but it had some 
important defects. The bearers who went forward with their 
companies were not always available for relay work. Large 
numbers of wounded of different units came through some and 
not through others of the aid posts, so that the bearers and 
stretchers of the battalion carrying on the relays were in some 
cases too few to cope with the work. When the 4th Australian 
Division passed through in the afternoon of the 7th June, many 
of their wounded had also to be brought back by the battalion 
bearers of the 25th Division. It happened too, in one or two 
cases, that the battalion bearers carried wounded back to the 
advanced dressing station and were consequently a long time 
away from their battalions, so that when the relay in front 
arrived at the aid posts with wounded no bearers were for the 
time being at the aid post to carry them on to the next relay. 
German prisoners, however, were employed on their way to the 
rear to carry wounded on improvised stretchers made of duck 
boards and other material, and were thus of great assistance. 
Normally it is the bearer division of field ambulances that 
would establish a system of relays for bringing back wounded 
to an advanced dressing station from regimental aid posts, 
and on the whole the method adopted by the A.D.M.S. of the 
25th Division, even in the circumstances of this attack, did not 
work as well as the normal method probably would have done. 

The IXth Corps.— The IXth Corps, (D.D.M.S., Colonel J. B. 
Wilson), held the centre of the attack with the 16th, 19th and 
36th Divisions and with the 11th Division in reserve. On the 
9th June the 16th and 36th Divisions on the right and left of the 
attack were withdrawn from the line, and it was then held by 



THE BATTLE OF MESSINES 129 

the 11th Division on the right and the 19th Division on the left, 
the front having then been contracted to 2,225 yards. The 
depth of the advance had been 4,500 yards. 

The headquarters of the corps were at Mont Noir. Main 
dressing stations and walking wounded collecting stations were 
prepared for each of the three divisions, in this way differing 
from the other corps, which prepared corps main dressing 
stations. For the right division the main dressing station was 
at Dranoutre, with a walking wounded collecting station at 
Donegal Farm, about one mile farther east on the southern 
slopes of Mont Kemmel. The centre division had its main 
dressing station in a hospice at Locre, with its walking wounded 
collecting station in a field near the junction of the Kemmel- 
Westoutre and Kemmel-Locre fork roads, about 1,000 yards 
east of the main dressing station. The left division had its 
main dressing station at Westoutre, and its walking wounded 
collecting station at La Clytte. There was a corps rest station 
for the sick of the corps at a small farm, Keerseboom, about 
two miles north-east of Bailleul. 

The main dressing stations were organized with accommoda- 
tion for 425 at Dranoutre, 700 at Locre, and 420 at Westoutre, 
and the walking wounded collecting stations connected with 
them for 300, 400 and 400 respectively. The corps rest station 
had accommodation for 600 sick or lightly wounded, 200 beds 
being allotted for each of the 36th, 16th and 11th Divisions, 
while the 19th Division established a separate rest station for 
150 beds at Westoutre. 

The advanced dressing stations feeding these main dressing 
stations were at Lindenhoek for the right sector, at Kemmel 
Brewery for the middle sector, and at the Laiterie on the 
Kemmel-Vierstraat road for the left sector, with another 
farther north at Kleine Vierstraat. 

The regimental aid posts were all situated in communication 
trenches and at or near trench tramways. These tramways 
were to be used as much as possible for evacuating to the 
advanced dressing stations, on the positions of which they 
converged. 

The positions of collecting posts for walking wounded were 
selected so that the walking wounded could be directed away 
from the advanced dressing stations and thus avoid congestion 
at the latter. The general arrangements were made with the 
object of keeping the line of evacuation for serious cases, as far 
as possible, apart from the line of evacuation for the light cases. 
Consequently the walking wounded collecting stations were so 



130 MEDICAL HISTORY OF THE WAR 

situated that they could be reached by cross-country tracks 
from the front. The tracks were marked with red cross guiding 
flags and box lanterns. From the collecting posts walking 
wounded were transferred by horse transport, buses and lorries, 
and full advantage was taken of returning supply and ammuni- 
tion trains on the broad gauge and light railways, whenever 
they were available. 

The divisional trench tramway officers took up their position 
in or near the advanced dressing stations, and were responsible 
that the trollies, which were fitted with gates for carrying 
stretchers and were drawn by mules, were supplied to the 
regimental aid posts as fast as the number of casualties re- 
quired, and that breaches in the line, which were of frequent 
occurrence from artillery fire, were repaired as rapidly as 
possible. 

Two officers and twenty other ranks were placed on duty at 
the Duke of York's siding on the railway line just east of 
Bailleul to receive the walking wounded cases from trains 
coming back from the front, and conduct them to No. 11 
CCS. A similar party was posted at Wippenhoek Siding 
south of Remy Siding to receive and detrain any wounded 
arriving from La Clytte by railway, and conduct them either 
on foot or by ambulance transport to the casualty clearing 
stations at Remy Siding. 

A convalescent camp for about 1 ,000 patients likely to be fit 
for duty within four or five days was established at Berthen, 
about halfway between Bailleul and Poperinghe. 

All these posts were formed by field ambulances or sections 
of field ambulances of the divisions. 

In order to assist the regimental stretcher bearers in collecting 
wounded, divisional commanders were instructed to provide, 
if possible, 100 extra bearers from each brigade. They were to 
be held in readiness at advanced brigade headquarters and 
supplied with stretchers sent up to the regimental aid posts. 
The field ambulance stretcher bearers were responsible for 
evacuating the wounded from the regimental aid posts, mainly 
by means of the trench tramways. The R.A.M.C bearers had 
been trained for some months beforehand in the use of trollies 
with gate ends fitted on them so that each trolley could com- 
fortably carry four lying down cases and their kits. This scheme 
worked admirably and wounded were brought back quickly and 
in good condition. German prisoners were also utilized as 
bearers and were of the greatest assistance. The system of 
bearer relay posts and the situation of regimental aid posts are 



THE BATTLE OF MESSINES 



131 



well illustrated in the following sketch map of the 36th Division 
medical situation during the battle. 

-L/ccne-THE &ATTLE OF MESSINES. -/9/7- 
Map of Medical. Situation Front Area 36 r - M Division. 
Smowinq system of Relay Posts. 




■+* Rsa.'AoPtarr. 
— <*- Line oramcuA.'noM. 

IOOO 



900 O 

1 ■ . I > | 



The advanced dressing stations were large shell-proof dugouts 
j or cellars at points where motor cars could be brought up. 

The main dressing stations were in large Nissen hospital huts, 
marquees or buildings. 

The motor ambulance convoy was worked on the continuous 
chain principle, that is to say, a car was sent to each main 
dressing station every six minutes during the acute phase of the 
: attack. This system worked very successfully, and the convoy 
kept well in advance of the situation, evacuating 2,200 cases to 
the casualty clearing stations between 3 a.m. on the 7th June 
and noon on the 10th June. 

Between La Clytte and Wippenhoek three special trains 
were employed for conveying the walking wounded from the 
former post, and in addition a lorry service was organized, a 
lorry being sent to each of the three walking wounded collecting 
posts two hours after the attack was launched and every half 
hour afterwards so long as the fighting continued. These lorries 
were fitted with bench seats and palliasse cushions, and had 
ladders with a hand rail for assisting the wounded to get into 
them. 

Colonel Bo wen, the A.D.M.S. of the 16th Division, was 
seriously wounded in the chest by a shell fragment on the 8th 



10134 



132 MEDICAL HISTORY OF THE WAR 

June while visiting the regimental aid posts, but fortunately 
recovered and returned to France in February 1918. 

The Xth Corps. — The Xth Corps held the sector on the left 
flank of the attack south-west and north-east of the Yser Canal 
from the Diependaal Beek to Observatory Ridge. It had the 
Ilnd Corps on its left in the short sector between the Ypres- 
Menin road and Observatory Ridge. Its divisions were the 
41st, 47th and 23rd, with the 14th in reserve. The D.D.M.S., 
Colonel R. L. R. Macleod, had his headquarters somewhat far 
back at Abeele on the Belgian frontier. 

The front area, including the Ilnd Corps sector, before it was 
handed over to the Fifth Army, consisted of four sectors ; 
from right to left, the St. Eloi sector, the Bluff sector, Obser- 
vatory Ridge sector, and the Hooge sector. A series of collecting 
posts was prepared behind each of these sectors at Voorme- 
zeele, Spoilbank, the Bluff, Cow Farm and Menin Mill, with a 
series of advanced dressing stations farther back at Dickebusch, 
Woodcote Farm, the railway embankment, the Zillebeke Bund, 
and the asylum at Ypres. Farther back there was one large 
corps collecting post on the Ypres-Dickebusch road, south-west 
of Kruisstraat, to which both lying down cases and walking 
cases were brought, and from there sent to a main dressing 
station with accommodation for 600 seriously wounded, and 
another for 1,000 lightly wounded at Brandhoek, the former 
being in a school south of the railway, and the latter in tents 
on the north side. There was also a main dressing station for 
800 lightly wounded on La Clytte road half-way between La 
Clytte and Reninghelst. There was a divisional rest station for 
each division with accommodation for 400. 

A special feature in the arrangements of the Xth Corps was 
the preparation of a collecting post at Vlamertinghe Mill for the 
reception of casualties from gas poisoning. The month of June 
was considered by the gas experts as a specially favourable 
month for attacks by lung irritant gases, and this fact had been 
brought to the notice of the corps and divisional D.Ds.M.S. and 
A.Ds.M.S., but the Xth Corps appears to be the only corps 
which made separate arrangements for collecting and evacuating 
the gas casualties. 

The lightly wounded from other sectors than the St. Eloi 
sector, which cleared to La Clytte, were brought to Brandhoek, 
either through the corps collecting post or by way of a post at 
the Lille Gate of Ypres, or through Ypres and by way of the 
advanced dressing station at the asylum. The seriously wounded 
went to the main dressing station at Brandhoek, either direct 
or through the corps collecting posts. 



Diagram showingXCorps scheme of evacuation 



FOR CASUALTIES IN PREPARATION FDR 

THE Battle of Messinesv June 1917. 



Lying down & car cases. 

*■ Walking & lorry casks. 



K'oN^ v Gas and car cases. 

HoTE t A/t/Mae*s USBS3SSS. 

^ +TION AT £ACH POST 




t3.284BC 5060/I4-I. t5QO.ll.23 



H.M.S.O.Ci 



THE BATTLE OF MESSINES 133 

The general scheme is shown on the diagram, which was 
prepared by the D.D.M.S. of the Corps in May ; but as the 
Ilnd Corps took over the Hooge sector before the attack 
of the 7th June, these arrangements were modified to some 
extent. 

The walking wounded cases were evacuated at first to the 
casualty clearing stations at Remy Siding, but this was altered, 
and the lightly wounded from Brandhoek were subsequently 
cleared to the casualty clearing stations at Mendinghem. 
Some of the lightly wounded, however, from the dressing 
station on the La Clytte road went direct to the divisional rest 
stations. 

The lightly wounded were brought back from the advanced 
dressing stations by horsed ambulance wagons, empty supply 
lorries or general service wagons to the dressing station at 
Brandhoek, and the seriously wounded by a motor ambulance 
convoy improvised by the D.D.M.S. out of the ambulance 
cars of the divisional field ambulances. It assembled on the 
road between Kruisstraat and Vlamertinghe. From the 
collecting posts and advanced dressing stations wounded were 
taken to the corps collecting station or to the advanced dressing 
station at Dickebusch by hand carriage or trench tramways. 
Motor lorries were employed for conveying lightly wounded 
from Brandhoek to the casualty clearing stations. Arrange- 
ments were also made for ambulance trains or temporary 
ambulance trains being run as far as Brandhoek to clear both 
the dressing stations there to the lines of communication or 
bases direct, if necessary. This is well illustrated in the 
diagram of the scheme of evacuation in the 23rd Division. 

But practically all the regimental aid posts, collecting posts, 
and advanced dressing stations were situated at or near trench 
tramways, and, as far as possible, the wounded were brought 
back on these by field ambulance bearers. The chief difficulty 
experienced in this method of evacuation was the frequent 
damage to the lines by artillery fire. 

In addition to the trench tramways, a light railway ran 
from the front areas to a point known as Wellington Junction, 
situated about one and a half miles south of Brandhoek. From 
there a light railway ran to join the main line west of Brandhoek 
Siding. Wounded, who might arrive by the light railway at 
Wellington Junction, were received there by a field ambulance 
detachment and sent to Brandhoek by a shuttle service of 
trains. There was another light railway running from Zeve- 
coten, near Reninghelst, to Wippenhoek, where a divisional 

(10134) L* 



134 MEDICAL HISTORY OF THE WAR 

rest station of the 41st Division was established. It was used, 
when necessary, to bring lightly wounded from the walking 
wounded collecting station on the La Clytte-Reninghelst road 
by empty supply trucks direct to the rest station. 



Evacuation of the Wounded. 

Owing to the rapidity with which the wounded were coming 
into Bailleul, the casualty clearing stations there in the early 
morning of the 8th June became somewhat congested. This 
was specially felt at No. 53 CCS. in the asylum in the northern 
outskirts of Bailleul. Patients were then diverted from the 
southern sector of the IXth Corps to Remy Siding in order 
to relieve this congestion, No. 53 CCS. being closed for the 
reception of wounded for six hours. Lying-down patients were 
also diverted then to No. 11 CCS. in rotation with the other 
casualty clearing stations in Bailleul in place of No. 53. The 
congestion in Bailleul was further relieved by transferring 
patients by road to Hazebrouck, and by sending up a convoy 
of fifty cars from St. Omer, to transfer 400 patients to the 
hospitals in the St. Omer area. 

Much congestion was also experienced at Remy Siding in 
No. 3 Canadian CCS. by the number of lightly wounded 
patients arriving there. The arrangement by which casualty 
clearing stations were allotted for walking wounded only, did 
not, in fact, prove satisfactory. The orders on the subject were 
consequently cancelled during the battle, and all the casualty 
clearing stations at Remy Siding then received lying down 
cases in rotation, as in the case of No. 11 CCS. and those in 
Bailleul. 

The New Zealand Stationary Hospital had been transferred 
to Hazebrouck from Amiens on the 25th May as a special 
hospital for gunshot wounds of the head. The distinguished 
American surgeon, Major Harvey Cushing, who belonged to the 
staff of No. 11 (Harvard) General Hospital, was attached to 
it as operating surgeon during the battle. Owing to the large 
number of head cases requiring operation, which had accu- 
mulated at the New Zealand Stationary Hospital, fifty of them 
were transferred to No. 7 General Hospital, St. Omer, by road. 



TWO LEFT BATTALIONS 

L " T3. 



TWO CENTRE BATTALIONS TWO RIGHT BATTALIONS 



ADV. DRESSING STATION 
ZILLEBEKE BUND 



DIV. COLLECTING ST* 
FOR WALKING WDP 
LILLE GATE YPRES 
LORRY LOADING POINT 




FIELD AMB.H.Q. 

DRESSING STN. 
AND BEARERS CAMP 
VIAMERT1NGHE MILL 



DIV. REST STATION 
AND GAS TENTS 
WAR AT AH CAMP 



r^*y\ CORPS MAIM DRESSING 
/Vr-f-k. STATION FOR SEVERELY 
*~??l WOU 

/ / 

/ 



CASUALTY CLEARING ST" 
REMY SIDING 



S&fiftj r J ~l j •• • »» Fj-fi'i iTiT) (T7. 777} fTTTTTTT [7777771 



WALKING WOUNDED 
STRETCHER CASES 
GASSED. 



ALTERNATIVE ROUTES 
ALTERNATIVE ROUTES 



Scheme of Evacuation of Wounded from the 23 r - Division 
during the Battle of Messines. 

Malby&SonsXith. 



THE BATTLE OF MESSINES 

The Casualties. 



135 



The number of wounded admitted to the medical units of 
the three Corps during the first three days of the battle was as 
follows : — 





Ilnd Anzac 
Corps. 


IXth 
Corps. 


Xth 
Corps. 


Total. 


7th June 

8th June 
9th June 


4,414 
3,103 

1,350 


2,368 
898 
339 


1,963 
2,097 
1,027 


8,745 
6,098 
2,716 


Totals 


8,867 


3,605 


5,087 


17,559 



The wounds were on the whole very severe, and were mainly 
caused by high explosive shells and shrapnel. Only about 5 
per cent, were attributed to rifle or machine gun bullets. 

The number of gassed patients during the battle was con- 
siderable. Most were in the Ilnd Anzac Corps area and went 
to No. 2 Australian CCS. Some battalions which advanced, 
before the creeping barrage had lifted, sustained casualties 
from the fire of the British guns. 

The casualties amongst the personnel of the medical services 
were : — 

Officers Killed .. 4 

Wounded . . 6 

Other ranks Killed .. 24 

Wounded .. 130 

Some records were kept in one or more divisions of all three 
corps to show the proportion of stretcher cases to walking 
cases collected by their field ambulances. The results are 
shown in the following table : — 



Division. Period. 


Total collected. 


Percentage of total. 


Walk- 
ing. 


Sit- 
ting. 


Lying. 


Walk- 
ing. 


Sit- 
ting. 


Lying. 


N.Z. 3 a.m. 7th June") 

to \ 

9 a.m. 9th June J 

25th 3 a.m. 7th June*) 
to y 
Noon 9th June J 
19th 7th and 8th June 
41st &\ 
23rd / 


980 

2,879 

1,037 
2,912 


1,620 


1,232 


26 

61-9 

69-3 
69-8 


32 


42 


1,767 

459 

1,262 


38- 1 

30-7 
30-2 



136 MEDICAL HISTORY OF THE WAR 

An average of all these figures shows the percentage of walking 
cases to be 64-2 and of the lying cases 35-8 of the total, or 
approximately two walking cases to one stretcher case. 

The records, however, are not altogether satisfactory as a 
means of comparison, for the extent to which sitting cases 
were regarded as stretcher cases or as walking cases is not 
clear. 

The Weather. 

The weather was hot and on some days sultry, with heavy 
thunder showers on the evening of the 7th and 12th June, 
otherwise it was fine and generally the best possible weather 
for the work of collecting the wounded, whose comfort and 
treatment were thus in no way affected by unfavourable 
weather conditions. 



CHAPTER VIII. 

THE BATTLES OF YPRES, 1917. 

THE battles of Ypres in 1917 resembled in many respects 
the battles of the Somme in 1916 ; that is to say, they 
constituted a series of attacks, by a succession of divisions, over 
an extensive area of shell-devastated country with the object 
of driving the enemy from dominating positions on high 
ground. The operations were interrupted by heavy and 
continuous rains, and it was impossible to take full advantage 
of initial successes. The ground over which the troops fought 
became in many places " a succession of vast muddy pools. 
The valleys of the choked and overflowing streams were speedily 
transformed into long stretches of bog, impassable except by 
a few well-defined tracks which became marks for the enemy's 
artillery."* Successive attacks were consequently delayed 
until spells of fine weather, which were by no means frequent 
or prolonged, dried the ground sufficiently for the operations 
to be continued. 

The battles extended over the period 31st July to 10th 
November. After the opening battle on the 31st July, rain 
fell incessantly and operations were delayed until the 16th 
August, when they were again, on the 19th August, interrupted 
by weather conditions till the 20th September. 

Outline of the Operations. 

The attacks were successively directed against the Pilckem 
Ridge (31st July to 2nd August), Langemarck (16th to 18th 
August), Menin Road Ridge (20th to 25th September), Polygon 
Wood (26th September to 3rd October), Broodseinde (4th 
October), Poelcappelle (9th October), and Passchendaele in two 
attacks on the 12th October and between the 26th October 
and 10th November. 

In the Battle of Pilckem Ridge the Ilnd (24th, 30th and 
8th Divisions), XlXth (15th and 55th Divisions), XVIIIth 
(39th and 51st Divisions), and XlVth Corps (38th and Guards 
Divisions), all in the Fifth Army, with the 41st Division of the 
Xth Corps, Second Army, supporting the right of the attack, 

* Sir Douglas Haig's despatches, p. 116. 



138 MEDICAL HISTORY OF THE WAR 

were engaged from in front of Klein Zillebeke to Boesinghe, 
and French divisions extended the attack on the left between 
Boesinghe and Steenstraat. An advance of approximately 
two miles in depth was made, reaching the enemy positions 
from Westhoek to St. Julien and along the line of the Steenbeek 
beyond the Pilckem Ridge. 

In the Battle of Langemarck, on the 16th to 18th August, 
the divisions chiefly engaged were the 56th and 8th in the 
Ilnd Corps, the 48th and 11th in the XlXth Corps, and the 
29th and 20th in the XlVth Corps. The line was then advanced 
to Langemarck, but was little changed in other sectors. 

After this wet weather continued. For the subsequent 
battles, which were fought in order to capture the Menin Road 
Ridge between Gheluvelt and Broodseinde, the Second Army 
front was extended northwards and the operations were con- 
ducted by it north and south of the Menin Road in conjunction 
with attacks by the Fifth Army further north. The 1st Anzac 
Corps had been transferred to the Second Army from the 
Third Army at the end of July, with the 1st, 2nd and 5th 
Australian Divisions, to which the 4th and 3rd Australian 
Divisions were added in August and October. The 25th and 
47th Divisions were also in the 1st Anzac Corps for a short 
time in August. The VHIth Corps, which had been a reserve 
corps of the Fifth Army, was restored to the Second Army at 
the beginning of September. The Canadian Corps, composed 
of the four Canadian Divisions, was transferred from the First 
to the Second Army in October ; so that during the battle on 
the Menin Road Ridge and subsequent battles the Second 
Army had at its disposal three corps in addition to those 
(Ilnd Anzac, IXth and Xth Corps) with which it had fought 
the battle of Messines. 

In the Battle of Menin Road Ridge on the 20th September 
the Xth Corps, with the 19th, 39th, 41st and 23rd Divisions, 
was engaged south of the Menin Road, and the 1st Anzac 
Corps, with the 1st and 2nd Australian Divisions, north of the 
road. The Fifth Army, further north, attacked along the 
Ypres-Roulers railway at the same time with the 9th and 
55th Divisions of the Vth Corps, which had previously been 
in reserve, and on their left north of the Zonnebeke-Langemarck 
road with the 58th and 51st Divisions of the XVIIIth Corps. 
The line was advanced to Polygon Wood and north of Lange- 
marck. The fighting was continued on the 26th September, 
chiefly by 1st Anzac Corps divisions (5th and 4th Australian) 
and Vth Corps divisions (3rd and 59th), with the 39th and 33rd 




MalbyiSonsLiUi 



THE BATTLES OF YPRES, 1917 139 

Divisions of the Xth Corps on their right flank astride the 
Menin Road and the 58th Division of the XVIIIth Corps on 
the left flank south-east of St. Julien. 

The Battle of Polygon Wood was a series of heavy counter- 
attacks which were continued into October. 

The Battle of Broodseinde was fought on the 4th October, when 
the Second and Fifth Armies renewed the attack, directing it 
against the main line of the ridge east of Zonnebeke from 
the Menin Road to the Ypres-Staden railway over a front of 
seven miles. Twelve divisions were engaged. The 37th of the 
IXth Corps south of the Menin Road, the 5th, 21st and 7th of 
the Xth Corps between it and Polygon Wood, the 1st and 
2nd Australian of the 1st Anzac Corps between Polygon Wood 
and the Ypres-Roulers railway, the 3rd Australian and New 
Zealand of the Ilnd Anzac Corps, which had been brought up 
from the right of the Second Army to its left flank, between the 
Ypres-Roulers railway and the Ypres-Gravenstafel road, the 
48th, 1 1th and 4th of the XVIIIth Corps on the right of the Ilnd 
Anzac Corps to Langemarck, and the 29th of the XlVth Corps 
astride the Ypres-Staden railway. The result of the battle 
was a great advance, and the British line was now established 
along the main ridge from the west of Gheluvelt through 
Broodseinde to the Ypres-Roulers railway, where it bent 
north-west to Poelcappelle and the Ypres-Staden railway, an 
advance of some 6,000 yards in greatest depth from the line 
held before the attack of the 31st July. 

Bad weather again continued, but notwithstanding the 
unfavourable conditions and the state of the ground the attack 
was renewed on the 9th October, when the Battle of Poelcappelle 
was fought in conjunction with the French First Army under 
General Anthoine from the east of Zonnebeke to near Merckhem. 
The Guards Division and the French on the left of the attack 
advanced across a flooded valley, a distance of nearly one and 
a half miles, to the Houthulst Forest. The 29th and 4th 
Divisions of the same Corps (XlVth) advanced along the 
Ypres-Staden railway to east of the Poelcappelle-Houthulst 
road; while the 11th and 48th Divisions of the XVIIIth 
and the 66th and 49th of the Ilnd Anzac Corps extended the 
attack from the east of Poelcappelle to Broodseinde, making 
some slight progress. 

On the 12th October the First Battle of Passchendaele took 
place. The attack was renewed between the Ypres-Roulers 
railway and Houthulst Forest by the 1st and Ilnd Anzac 
Corps and the XlVth Corps, but the constant rain prevented 



140 MEDICAL HISTORY OF THE WAR 

the operations being continued. They were renewed again 
on the 26th October in the Second Battle of Passchendaele, 
when the 3rd and 4th Canadian Divisions of the Canadian 
Corps made an attack up the valley of the Ravebeek and 
secured high ground south of Passchendaele. The advance 
was continued on the 30th October between the Ypres-Roulers 
railway and Poelcappelle-Westroosefyeke road by the 3rd and 
4th Canadian Divisions and the 58th and 63rd Divisions of 
the XVIIIth Corps on their left ; and again by the 1st and 
2nd Canadian Divisions on the 6th November, when the village 
of Passchendaele was captured. Some further progress north- 
wards from Passchendaele was made on the 10th November. 

The operations in Flanders then came to an end,* and a 
readjustment of army areas again took place, the Fifth Army 
being transferred to the area south of the Somme, and the 
Second Army headquarters to Italy, its place being taken by 
the Fourth Army headquarters, as already noted. 

Had the weather conditions permitted of a complete occu- 
pation of the Passchendaele ridge and the country beyond 
before winter set in, the operations of the Second and Fifth 
Armies were intended to be combined with operations of the 
Fourth Army on the coast ; but when further progress at 
Passchendaele ceased in November there was no longer any 
need for maintaining a British front in the Dunkirk-Nieuport 
area. The Dunkirk-Nieuport area was consequently re-trans- 
ferred to French troops at the close of the operations in Flanders. 

The progress made during the various attacks is shown on 
the map. 

General Medical Preparations for the Battles. 

The preparations made for the offensives, more especially 
those for which the D.M.S. of the Fifth Army was responsible, 
were based upon an anticipation of the complete success of 
the operations. 

The D.G.M.S. held a conference of Ds.M.S. of armies on the 
29th May 1917, when the requirements of the Fifth Army in 
its new area were considered. These necessitated the transfer 
of various medical units from other armies, in order to build 
up a medical strategical position in preparation for the part 
the army was to play after the Messines ridge had been captured 

* Although the operations described as the Battles of Ypres, 1917, came to 
an end on 10th November, raids and minor actions were continued on the Ypres 
front, especially in the vicinity of Poelcappelle, by the 1st Division which had 
arrived from the Dunkirk area. 



THE BATTLES OF YPRES, 1917 



141 



"by the Second Army. Consequently by the 21st July the Fifth 
Army had been well supplied with medical units of all descrip- 
tions, apart from the medical units of the divisions of which 
it was composed. Its D.M.S., Surg.-General B. M. Skinner, 
had then under his control the following units : — 

Casualty Clearing Stations — 

At Dozinghem . . . . Nos. 4, 47 and 61. 






At Brandhoek 

Remy Siding 

Mendinghem 
Bandaghem 



Nos. 32, 44 and No. 3 Austra- 
lian. 

Nos. 10, 17, Nos. 2 and 3 
Canadian. 

Nos. 12, 46 and 64. 

Nos. 62 and 63. 



Advanced Depots of Medical Stores — 

Dozinghem 

Proven . . 

Remy Siding 
Mobile Laboratories— 

Remy Siding 

Dozinghem 

Mendinghem 

Poperinghe 
X-ray Units — 

Remy Siding 

Dozinghem 
Motor Ambulance Convoy s- 

Proven 

Wippenhoek Farm 

Remy Siding (near) 

Poperinghe (near) at 
Chateau, Lovie Road. 

Winnezelle, between 
Steenvoorde and 

Herzeele. 



No. 18. 
No. 31. 
No. 2 Canadian. 

No. 1 Bacteriological. 
No. 8 Bacteriological. 
No. 11 Bacteriological. 
No. 23 Hygiene. 

No. 5. 
No. 7. 

No. 4 with the XlVth Corps. 
No. 6 with the XlXth Corps. 
No. 20 with the Ilnd Corps. 
No. 24 with the XVIIIth 

Corps. 
No. 31 as Army Reserve. 



The Fifth Army area had also ten sanitary sections distri- 
buted in it * 

Surg.-General Skinner had asked for fifteen casualty 
clearing stations, and a large number of hospital marquees 
and huts for them. Approximately 1,300 marquees and 60 
huts were given to him for sick and wounded alone, irrespective 

* Four more sanitary sections were asked for from the D.G.M.S. by the 
D.M.S. of the Fifth Army to arrive on the 13th August, in consequence of the 
new area that had been taken over from the enemy. 



142 MEDICAL HISTORY OF THE WAR 

of those required for personnel and other purposes. Each 
marquee could take 10 wounded and each hut 20, so that 14,200 
wounded could be accommodated comfortably at one time ; 
while at least 25 per cent, could be added to these numbers 
in emergency without inconvenience, bringing the total accom- 
modation up to 18,000. By crisis expansion it was estimated 
that shelter could be provided in these casualty clearing 
stations for 20,000 at one time. 

But the D.M.S. of the Fifth Army, not content with this 
ample provision, applied for an increase in the number of 
marquees on the 13th August, and the responsibility of granting 
or refusing these was placed on the D.D.G.M.S. by the Adjutant- 
General, who asked him if he was satisfied that the total tentage 
already given would meet all the requirements for the number 
of wounded likely to arise in any impending operations. The 
D.D.G.M.S. considered that they were adequate for reasonable 
requirements, with proper distribution and with the existing 
means of evacuation. An additional casualty clearing station, 
No. 13 from Tincourt, however, was sent to the Fifth Army, 
but was kept parked. The intention of the D.M.S. was to 
keep it in reserve in anticipation of an extensive advance, and 
sites were being prepared for it and others at Elverdinghe. 
It went, however, to Arneke eventually at the end of September, 
owing to the need of a casualty clearing station in a back area 
for the sick of the reinforcements which were being brought 
up from the base depots. 

On the 21st July the D.G.M.S. issued instructions for the 
coming offensive operations. Ds.M.S. of armies not actively 
engaged were to retain as many sick and wounded as possible in 
the casualty clearing stations and stationary hospitals in their 
areas, so as to avoid using ambulance trains and filling the 
accommodation in base hospitals. At St. Omer there were 
three general hospitals open, No. 7 at Malassises, No. 58 at 
the Champs de Mars, and No. 59 in the military hospital, 
St. Omer, for surgical cases, and at Moule Chateau, some 
five miles distant on the Calais road, for minor cases. There 
were also two stationary hospitals, No. 4 and No. 7 (Canadian), 
at Arques, and another stationary hospital, No. 4 (Canadian), 
was opening at the Chateau at Longnesse, near St. Omer. 
These hospitals were to receive sick from the back area of the 
Fifth Army, as well as sick and wounded arriving by road or 
barge from the Fourth Army in the Dunkirk area, or, in 
emergency, from the casualty clearing stations of the Fifth 
Army. 



THE BATTLES OF YPRES, 1917 



143 



The distribution of sick and wounded to the casualty clearing 
stations and St. Omer was regulated by the following instruc- 
tions, issued by the D.M.S. of the Fifth Army on the 24th 
July :- 

" On and after 9 a.m. on the 26th inst. the following groups of casualty 
clearing stations are allotted for the reception of sick and wounded from 
the areas detailed in the table. 

Attention is directed to the disposal of special cases. 
Note. — Forward Area is taken as E. of line Crombeke-Poperinghe-Abeele 
Station. 
Bach Area is W. of above line, and E. of line Bergues-Noordpeene 
Railway. 



Casualty clearing 
stations. 



Area. 



Re my Siding— 

Nos. 10, 17, 2 and 3 Cana- 
dian. 



Ilnd Corps. — All sick and wounded. 
XlXth Corps. — All wounded and sick from 
Forward Area. 



Proven (Mendinghem) 
Nos. 12, 46 and 64. 



Lachrymatory Gas cases from all corps. 
Head Injuries from all corps. 
XlXtk Corps. — All sick from Back Area. 
XVIIIth Corps. — Walking wounded when 

carried by vehicles other than motor 

ambulance cars. All lying sick from 

Forward Area. 
XIV th Corps. — Walking wounded when 

carried by vehicles other than motor 

ambulance cars. 



Dozinghem — 

Nos. 4, 47 and 61 

No. 4. 

No. 61. 

No. 47. 



XI Vth and XVIIIth Corps. — All wounded 

using ambulance cars. 
XI Vth Corps lying sick from Forward 

Area. 
Self-inflicted and Infectious. Also Eye 

Centre. 
Doubtful cases of N.Y.D. Gassed. 



Brandhoek. On Zero — ■ 
No. 32. 

On Zero + 2— 

Nos. 32, 44 and 3 Austra- 
lian. 



All abdominal cases from Ilnd, XlXth 
and XVIIIth Corps. 

All abdominal, severe chest injuries, and 
compound fractures of thigh from Ilnd, 
XlXth and XVIIIth Corps. 



Haringhe (Bandaghem) 
No. 63. 



No. 62. 



XI Vth and XVIIIth Corps.— All sick in 
Back Area and sitting sick from Forward 
Area. 

VI Ilth Corps. — All sick in Back Area. 

All N. Y.D.N, cases. 



All sick W. of line Bergues-Noordpeene Railway will be sent to 
St. Omer or Arques, except self-inflicted wounded, which will be sent 
to No. 61 Casualty Clearing Station." 

(10134) M 



144 MEDICAL HISTORY OF THE WAR 

A motor ambulance convoy was allotted to each corps 
holding a sector of the front : — 

No. 20 to the Ilnd Corps. 

No. 6 to the XlXth Corps. 

No. 24 to the XVIIIth Corps. 

No. 4 to the XlVth Corps. 
No. 31 M.A.C. was in army reserve directly under the 
D.M.S. 

A programme for ambulance trains was drawn up based on 
the anticipated occurrence of 20,000 wounded on the first day 
of the attack, and of diminished numbers on subsequent days. 
There were consequently garaged on the night preceding 
the attack 6 ambulance trains and 2 temporary ambulance 
trains at Hazebrouck and St. Omer ; 2 ambulance trains at 
Dozinghem and 2 at Bandaghem, 1 ambulance train and 1 
temporary ambulance train at Mendinghem, and 1 temporary 
ambulance train at Remy Siding. It was calculated that 
5 ambulance trains and 3 temporary ambulance trains would 
come up to Remy Siding during the first twenty-four hours, 
4 ambulance trains and 3 temporary ambulance trains to 
Mendinghem, and 4 ambulance trains to Dozinghem, capable 
of evacuating 12,000. On the second day trains were to run 
to evacuate 11,000, on the third day 7,000, and on the fourth 
day 5,000 ; each train after loading being immediately replaced 
by another from the garage. 

The Medical Services of Corps and Divisions in the Opening 
Phases of the Battles. 
The collection of wounded from the battlefield and their 
removal to collecting posts and advanced dressing stations was 
controlled by the A.Ds.M.S. of the divisions engaged. Most 
of the advanced dressing stations were along or in the 
vicinity of the Yser canal banks. The work of the regimental 
medical officers and stretcher bearers and of the field ambulance 
bearer divisions was immensely handicapped by the mud and 
marsh over which they had to collect and bring back the 
wounded. Trench tramways and light railways were frequently 
broken, and their extension, as the line advanced, was limited 
by the state of the ground. It was consequently only in 
comparatively short sections that they were able to relieve 
the bearers of hand carriage. Horsed ambulance wagons and 
motor ambulance cars were also restricted in their use in 
advance of the canal bank. Only a few roads were fit for 
wheeled traffic, such as the Menin, Zonnebeke and St. Julien 



THE BATTLES OF YPRES, 1917 



145 



roads, and even these for short distances only. Consequently 
most of the work of bringing wounded back had to be by 
relays of bearers. 

The general situation of the divisional and corps medical 
posts at the beginning of the operations is shown on the map. 

Each corps organized its own medical posts, the D.D.M.S. 
of the corps being made responsible for the evacuation of 
wounded from the advanced and main dressing stations to 
the casualty clearing stations in accordance with the distri- 
bution in the instructions quoted above. 

Ilnd Corps. — The organization of posts and scheme of 
evacuation prepared by the Ilnd Corps D.D.M.S., Colonel 
Guise Moores, is shown in the following map. 

Battles of Vpres 1917, 
Medical Organization M Corps Front Area on July 51 S - T 



gsGM-rt-.A/DPosT. ** &Ei^v Post © Coix*cr//va Post 

Q Walking Wounded Col.l-£c.t/no o/zD/z^ssjngStat-jo/v. 
JJ Advanced Dress/no ^Station. F3 Cogps if a /n £te<e&s//v& Stat/on 

r¥&s* B/ZOAD aUAOE KAJLMfAY . ++++>■ Ll ON T &A/L WAY . *— *— t- *— t— 7fiA\MIYAY. 



Of 7T7//&S. *~ 




Note. Ajzjsows /md/cats koaos usso and o/aex^r/OAf f=xxe ei*AGUArr/OAf. 



Two corps main dressing stations, one for seriously wounded 
and the other for walking wounded, were established near 
Dickebusch at a place to which the name of Dunedin was 
given. The former was manned by a tent division from a 
field ambulance of the 30th Division and by six tent sub- 
divisions from field ambulances of the 24th, 25th and 18th 



146 MEDICAL HISTORY OF THE WAR 

Divisions ; the latter by a tent division from the 8th Division 
and two tent sub-divisions from the 24th Division. A centre 
for dealing with gassed cases was formed in special marquees 
at the dressing station for severely wounded. 

In addition to the motor ambulance convoy allotted to the 
corps, the D.D.M.S. pooled the ambulance cars of the divisional 
field ambulances, with the exception of their Ford cars, and 
formed another corps convoy for clearing the advanced dressing 
stations to the main dressing stations. Twenty lorries were 
attached to it for clearing the walking wounded from the 
collecting posts to Dunedin. This convoy was assembled at 




The Prison, Ypres, used as a main dressing station. 

the Cafe Beige, as shown on the map. The collecting post 
on the Menin road was unfortunately damaged by fire during 
preparations for the battle and 500 stretchers were destroyed. 
The XlXth Corps.— The XlXth Corps D.D.M.S., Colonel 
O. R. A. Julian, established two corps main dressing stations 
at Brandhoek and at the Red Farm, some 1,000 yards further 
back, with a corps walking wounded dressing station at 
Vlamertinghe Mill. Regimental aid posts had been specially 
constructed, two for the right division on Cambridge road, 
between the Ypres-Roulers railway and the Zonnebeke road, 
and two for the left division on Oxford road, between the 
Zonnebeke and St. Julien roads. The advanced dressing 
stations to which the casualties were brought from them were 



THE BATTLES OF YPRES, 1917 



147 



at the Ypres prison, or, as an alternative, at Kruisstraat in 
the event of the former being shelled ; and on the canal bank 
north of Ypres. There was a light railway from St. Jean to 
the Red Farm, and wounded could be sent back by it to the 
corps main dressing station at the latter place. 




Collecting post close to Lille Gate, Ypres. 

It was doubtful whether the collecting post on the Menin 
road could be cleared through Ypres, but a new road had been 
formed around Ypres to Kruisstiaat, and it was arranged that 
if the cars could not pass through Ypres, stretcher cases should 
be taken by wheeled stretchers over this road to Kruisstraat 
and thence by car to the corps main dressing station. 

For use on the light railway running to the Red Farm 50 sets 
of stretcher frames had been made and adapted for fitting on 
the trucks. Each truck could thus carry 8 lying and 4 sitting 



148 



MEDICAL HISTORY OF THE WAR 



cases, or 16 sitting cases. There were ten of these trucks to each 
train, which was calculated to make four journeys in twenty- 
four hours. A nursing orderly was appointed to each of the 
trains. Less severely wounded could also be sent back on any 
of the supply trucks returning empty along this line. 

A light railway was also available for walking wounded from 
Kruisstraat to Vlamertinghe Mill, and arrangements were made 
to send back wounded on the broad-gauge line between 
Vlamertinghe and Remy Siding to the casualty clearing stations 
at the latter place. For this purpose trains were improvised 
by ten large trucks running every two to four hours, each truck 




Potijze Road, Ypres Salient. 



accommodating thirty sitting cases. These train services were 
intended to be supplementary to the bus and lorry service, 
so as to avoid any accumulation of wounded at the dressing 
stations pending the arrival of the cars. 

The motor transport of the field ambulances remained under 
the orders of the A.Ds.M.S. of divisions, and was not pooled, 
as in some other divisions, to form a corps motor ambulance 
convoy. Fifteen charabancs had been placed at the disposal 
of the corps by the Fifth Army, and in addition ten lorries were 
added from the corps itself. They were used for clearing the 
corps walking wounded dressing station to the casualty clearing 
stations and to the corps rest station. Supply lorries were 



THE BATTLES OF YPRES, 1917 



149 



running as far as Potijze, and the empty returning lorries could 
be used for bringing the less severely wounded to Vlamertinghe 
Mill. 

The medical situation in the XlXth Corps is shown on the 
following map. 

Battles of Ypres 1917. 
Medical Situation XJK Corps Front Area on July3I s . t 



+ Re&mcntai-Aid Post • Coi-lmctwq Post. Q Advanced D*z£s<s'mg <Stat/on 

E^^AUKIHOWOUNQED D8.ESS/N0STAT/ON . Q MAIN DtZESS'*«9 STATtON . 

<- Buoao CuAQ£ Kajlsvay -»»■>-■ >- Light Rah-way. Affz/eox.Sx.ryzoA/TL/MS. 
, . „ J O \ Z 3 4- 5 
5cei/<? erf m//es. I + 1 1 1 —l 1 




Farm 



Siding-. 



Oetra/n/ no point 
for Walking Myunded : 



The XVIIIth Corps.- -The XVIIIth Corps (D.D.M.S., 
Colonel E. G. Browne) had similar arrangements. The regi- 
mental aid posts were grouped. The divisions in both sectors 
had two grouped aid posts each, as shown on the map, with 
two advanced dressing stations — one on the canal bank at 
Duhallow, opposite Noordhofwijk, and the other at Essex 
Farm, just north of the Brielen-St. Julien road. 

A corps main dressing station for seriously wounded was 
established at Gwalia Farm, half-way between Poperinghe 
and Elverdinghe ; and for walking wounded near Vlamertinghe 
on the Vlamertinghe-Elverdinghe road. There were also a 
corps collecting station for sick and an officers' rest station at 
Poperinghe, a corps scabies centre at Eikhoek, east of the 
Poperinghe-Proven road, and a corps rest station in the back 
area at Herzeele on the road from Poperinghe to Wormhoudt. 

A complete tent division of a field ambulance was allotted 
to the advanced dressing station and divisional collecting 
post of each division, and the bearer divisions of all three field 
ambulances of each division were employed under orders of 
the divisional A.D.M.S. for collecting and evacuating the 
casualties. 



150 



MEDICAL HISTORY OF THE WAR 



The accommodation at the corps main dressing station for 
the seriously wounded was sufficient for 1,000. It was divided 
into two sections, each manned by a tent division of a field 




Corps main dressing station at Gwalia Farm. Ypres Front 1917. 

ambulance from each of the two attacking divisions. It was 
intended in this way to deal with the wounded of each division 
separately by one of its own field ambulances. 




Barn used as reception room in a corps main dressing station 
at Gwalia Farm, Ypres Front. 

Similarly the corps walking wounded dressing station was 
manned by two tent sub-divisions, one from each of the two 
assaulting divisions. 






THE BATTLES OF YPRES, 1917 151 

The corps sick collecting station and the corps scabies 
depot were each manned by a tent sub-division from one of 
the attacking divisions. 

The corps rest station at Herzeele was sufficient to accommo- 
date 700 patients, and was capable of expansion to 800. It 
was manned by two tent sub-divisions — one from each of the 
two divisions in reserve. 

The disposition of the field ambulances of the XVIIIth 
Corps divisions on the night of the 30th/31st July was conse- 
quently as follows, and is instructive as exemplifying the use 
of field ambulances as then organized : — 

39th Division. — Three bearer divisions under orders of the 
A.D.M.S. for bringing wounded to the canal bank. One tent 
division manning the divisional collecting post and advanced 
dressing station. One tent sub-division at the corps walking 
wounded collecting station. One tent division on duty at the 
corps main dressing station, and two tent sub-divisions packed 
and parked, ready to move if necessary, at the corps main 
dressing station. 

51 st Division. — Three bearer divisions under orders of the 
A.D.M.S. One tent division for the divisional collecting post 
and advanced dressing station. One tent sub-division at the 
corps walking wounded collecting station. One tent division 
at the corps main dressing station, and two tent sub-divisions 
at the corps sick collecting station and corps officers' rest 
station. 

llth Division. — In reserve. One field ambulance parked at 
the corps main dressing station. One field ambulance parked 
off the Poperinghe-Elverdinghe road about one and a half 
miles north-west of Poperinghe. One field ambulance, less a 
tent sub-division, parked about the same distance north of 
Poperinghe on the Poperinghe-Proven road, and one tent 
sub-division at the corps rest station. 

48th Division. — Field ambulances parked as in the case of 
the llth Division, less one tent sub-division at the corps rest 
station. 

The whole of the work of collecting and evacuating east of 
the canal bank was under the direction of the divisional 
A.Ds.M.S., but from the canal bank backwards the corps 
D.D.M.S. took over the control of evacuation. 

The A.Ds.M.S. of divisions were responsible for flagging their 
sectors to show the direction in which the various posts lay. 
Each division was allotted 20 wheeled stretcher carriers, 
6 horsed ambulance wagons, and 6 Ford ambulance cars. 

(10134) n 



152 



MEDICAL HISTORY OF THE WAR 



Tramway lines ran from the positions of the regimental aid 
posts to the canal, and were also available for conveying 
wounded to the advanced dressing stations. Eight trollies 
capable of carrying four stretchers each and 20 carrying one 
stretcher each were placed at the disposal of the A.D.M.S. of 
the assaulting divisions. Directing boards also indicated the 
route to the corps walking wounded dressing station and the 
corps main dressing station. It was intended that the walking 
wounded should make their own way back from the canal 

Battles of Ypres 1917. 
Medical Situation Front Area xviii & xiv Corps on July3I s . t 



+ fee Ax> Post. *%£lay&>st. & Dysnl. . Coll^ct/ng Post. j& kf*urMG k(*Maer> Cm i Ai^r 

Q Advaaicco DfiurssiNQ Station. gj CoeAs Ma*h Q&KS&H& Stat/cw. 

+**+ 3*OAD6weE Railway. ■**** Ijsht Rajlway. -*■-*— Tgamway. «■ ~— » Cofu>s &ot//*oA/eY. 



Scale i 

M/'/es. » » 'i » i i 




bank to the walking wounded collecting station by cross- 
country tracks and by the roads marked with directing boards, 
but lorries returning empty from the canal bank could pick 
them up, if necessary. 

No. 24 M.A.C., which had been allotted to the corps, was 
assembled at the corps main dressing station. It was reinforced 
by fifteen motor ambulance cars from each of the four divisions 
of the corps, so that the officer commanding the motor ambu- 
lance convoy had 110 motor ambulance cars under his control 
for evacuating from the advanced dressing stations to the 
corps main dressing station and from there to the casualty 
clearing stations. Advanced car posts were established 
between the corps main dressing station and the advanced 



THE BATTLES OF YPRES, 1917 153 

dressing stations, from which cars went up to the latter as 
cars returned from them. Fifteen charabancs were also 
allotted to the corps for clearing the walking wounded from 
the corps walking wounded dressing station near Vlamertinghe. 

The XlVth Corps.— The XlVth Corps (D.D.M.S., Colonel 
Whaite), on the extreme left of the British line and on the right 
of the French, had four advanced dressing stations, three for 
the 38th Division, on or east of the canal bank, and one for 
the Guards Division, at the Old Mill, just north of Elverdinghe. 
These were the two attacking divisions in the first phase of 
the battle. 

The corps main dressing station was established at Canada 
Farm, north of the Elverdinghe-Poperinghe road, about 
one and a half miles west of Elverdinghe. It was manned 
by two field ambulances, one from the 38th and the other 
from the Guards Division. 

The corps walking wounded dressing station, manned by a 
tent division of a field ambulance of the 20th Division, was 
established at Mouton Farm, on the same road about half a 
mile west of Elverdinghe. 

There were divisional walking wounded collecting posts, 
one for the 38th Division at Mordacq Farm, half-way between 
Elverdinghe and the canal, and the other for the Guards 
Division at Bleuet Farm, half-way between Elverdinghe and 
Boesinghe. These were cleared by auxiliary buses to Mouton 
Farm, and from there by other buses to Mendinghem. Fifteen 
auxiliary buses were allotted to the corps for this purpose. 

The divisional motor ambulance cars cleared from the 
advanced dressing stations to the corps main dressing station, 
and the Ford cars were sent as far forward on the tracks east 
of the canal as possible to help the work of the stretcher bearers. 

The corps main dressing station was cleared by No. 4 
M.A.C., but ten ambulance cars were allotted to clear direct 
to the casualty clearing stations from the advanced dressing 
station of the Guards Division, and ten to clear from the 
38th Division advanced dressing stations. These cars were 
situated at the corps main dressing station. The remaining 
cars were available for evacuating from the corps main dressing 
station to the casualty clearing stations at Dozinghem and 
Mendinghem. 

During the attack the Guards Division advanced dressing 
station moved from the Old Mill to Bleuet Farm, and all the 
motor ambulance transport of the field ambulances of the 
division were brought up to it. In the early morning of the 



154 MEDICAL HISTORY OF THE WAR 

31st July a motor ambulance car was brought up to Boesinghe 
and a loading post established there. This was the first 
wheeled transport to enter Boesinghe. In the afternoon a 
horsed ambulance wagon was got across the canal, but was 
unable to proceed far owing to the condition of the ground. 
It had to be left there. 

The approximate number of wounded of the Guards Division 
that were cleared to the corps walking wounded collecting 
post and main dressing station up to noon on the 2nd August 
was 52 officers and 1,468 other ranks, exclusive of wounded 
of other divisions, corps troops, and prisoners. No great 
accumulation of wounded occurred owing to the fact that the 
casualties were thus comparatively small. But the A.D.M.S. 
of the division, Colonel Fawcus, considered that if there had 
been large numbers the accumulation of wounded at the 
advanced dressing stations would have been excessive and 
that it would have been difficult to deal with them in accordance 
with the orders issued by the Corps D.D.M.S., which were 
to the effect that all the cases were to be dressed before being 
sent back direct to casualty clearing stations. 

In commenting upon this order in his diary, Colonel Fawcus 
noted that if such a procedure was to hold good on future 
occasions more medical officers would have to be provided 
and larger accommodation made at the advanced dressing 
stations ; and this would have necessitated the advanced 
dressing station being established much further back. He 
expressed the opinion that for an advance it was best to move 
and keep the advanced dressing station as near the line as 
possible, moving it as the line advanced ; in fact, to make the 
advanced dressing station a loading post only and to clear all 
cases from it as rapidly as possible to a place further back, 
where the necessary dressings could be carried out in comfort. 
This procedure would have been in accordance with the 
R.A.M.C. Training Manual and Field Service Regulations ; 
an advanced dressing station, as laid down in them, was not 
intended to be more than a post at the place where wounded 
brought back on stretchers could be loaded on to wheeled 
traffic. It is of some interest, therefore, to find a comment 
on the effects of a departure from this principle in consequence 
of an actual battle experience. 

Subsequent Phases of the Battles. 

During the subsequent phases of the battles of Ypres in 
1917 there was very little change in the general distribution 



THE BATTLES OF YPRES, 1917 155 

of advanced and main dressing stations in the schemes of 
evacuation. The Second Army gradually took over ground 
from the Fifth Army, extending its line northwards by the 
1st Anzac, Ilnd Anzac, and Canadian Corps. The Vth Corps 
had relieved the XlXth Corps from Fifth Army reserve on 
the 7th September, and was then on the left of the 1st Anzac 
Corps of the Second Army. It took over all the medical positions 
of the XlXth Corps. Its 9th and 55th Divisions took part in 
the battle of the 20th September. It was relieved on the 
27th September by the Ilnd Anzac Corps, and withdrawn to 
a back area. 

The Casualty Clearing Stations. 

The casualty clearing stations at Remy Siding were restored 
to the Second Army on the extension of its front, its other 
casualty clearing stations being at Godewaersvelde (Nos. 11, 
37 and 41), at Oultersteene, near Bailleul (No. 2 and No. 1 
Australian), No. 53 CCS. at Bailleul, No. 2 Australian CCS. 
at Trois Arbres, and No. 50 at Mont des Cats. 

A new casualty clearing station site, named Nine Elms, had 
been established near Poperinghe b}/ the D.M.S., Fifth Army, 
early in September to take the place of the casualty clearing 
station site at Brandhoek. The site at Brandhoek had always 
been regarded as too far forward and too much exposed to 
the danger of shell-fire, but the Fifth Army Commander 
and his D.M.S. were desirous of retaining Brandhoek as a 
large casualty clearing station centre, with accommodation for 
some 3,000, in anticipation of the line advancing. The fears 
regarding this site were justified, for the three casualty clearing 
stations at Brandhoek, Nos. 32, 44, and No. 3 Australian, 
were shelled out on the 21st August, before the extensive 
accommodation provided by them had been of any material 
value. It was then decided to evacuate all the wounded by 
ambulance trains at once, and the nursing sisters were sent 
away. One of the nursing sisters had unfortunately been killed 
by a shell, and as shells were falling on the railway platform 
it was not possible to send an ambulance train to clear the 
wounded. The patients, however, were brought back by 
road to Remy Siding, and it is remarkable that five of them, 
two suffering from abdominal and three from chest wounds, 
who had been operated on during the day and were taken back 
to No. 10 CCS. at Remy Siding, apparently suffered in no 
way by the journey ; and all — except one, who died six days 
later, and one of those wounded in the chest, who happened to 



156 MEDICAL HISTORY OF THE WAR 

be among the most severely injured and was therefore retained 
in No. 10 CCS. — were sufficiently recovered to be transferred 
to the base by the end of the month. The two abdominal 
cases, it may be noted, had multiple perforations of the intestine. 

This experience is of some importance as showing that a 
journey of twenty minutes to half-an-hour to a more secure 
locality farther back is not likely to be so great a risk to 
the patient as his retention in a more forward position which 
is in danger of being shelled by the enemy. The delay in 
getting a seriously injured abdominal case operated upon at 
the earliest possible moment was not, in fact, so much due to 
the length of the road journey back by ambulance car, as to 
the time taken in bringing him from the place where he fell 
to the point where he could be loaded on to the car. Colonel 
Soltau, the consulting physician of the Northern Armies, it 
may be noted, had also made an emphatic protest to the D.M.S. 
against retaining serious chest injuries in the forward position. 
The surgeons on duty at Brandhoek had also reported that the 
noise of artillery fire in the vicinity had a bad effect on the 
wounded, and that the locality was not suitable for retaining 
them under treatment, and the determination of the Army 
Commander and his D.M.S. to retain casualty clearing stations 
there must be regarded as strategically unsound from a 
medical point of view. 

No. 44 CCS. was the first of the Brandhoek casualty 
clearing stations to reopen at Nine Elms. No. 3 Australian, 
after being parked during September at Remy Siding, opened 
there at the end of the month under the Second Army D.M.S. 
No. 32 remained at Brandhoek for a considerable time for the 
reception of walking wounded only. Up to the time of the 
hostile shelling on the 21st August it had carried out most of 
the serious abdominal operations, as No. 44 and No. 3 Australian 
did not commence to take in wounded until the 9th and 16th 
August respectively. 

After Brandhoek had been abandoned the D.M.S. of the 
Fifth Army made preparations for bringing No. 32 CCS. 
and No. 10 CCS. to Elverdinghe still nearer the front. The 
D.G.M.S., however, refused to sanction this, and was supported 
by the G.O.C of the XlVth Corps, who considered the locality 
too far forward for casualties of his corps, which it served, being 
treated there. The distance was 9,500 yards from the front line 
and within easy range of enemy mobile artillery in Houthulst 
Forest. The site at Elverdinghe, however, was prepared and 
huts erected on it in anticipation of an advance, but casualty 



THE BATTLES OF YPRES, 1917 157 

clearing stations were not opened there at any time during the 
battles. A detachment of No. 10 CCS. had been sent to take 
over the site from Remy Siding, but was recalled by orders of 
the D.G.M.S., and the Army Commander was informed by the 
Adjutant-General that No. 10 CCS. was not to be removed 
from Remy Siding without instructions from G.H.Q. The 
site at Elverdinghe had been heavily shelled on the 29th 
August, and was continually exposed to artillery fire and 
bombing from the air. 

The desire, however, of the Fifth Army to have an advanced 
operating centre for abdominal injuries as far forward as 
possible was unabated, and positions such as Brielen, the cellars 
of the prison at Ypres and shell-proof dugouts were considered, 
but the consulting surgeons were not in favour of these being 
used. 

The officer commanding No. 32 CCS. and a portion of his 
staff took up their quarters at Elverdinghe on the 5th November. 
The equipment and tent age had been moved there on the 12th 
October, when it was found that 40 of the marquees had been 
so much torn by fragments of shell that they had to be returned 
to store for repair. On the 8th November, however, it was 
definitely decided that Elverdinghe could not become a casualty 
clearing station centre, and work on the site was stopped. 

The Work of Divisions and Corps. 

When the Second Army extended its front with the 1st and 
Ilnd Anzac and Canadian Corps, the chief features in the work 
of collecting and bringing back the wounded were the long 
distances and heavy ground over which the bearers had to 
carry stretchers. During the fighting of the 20th and 21st 
September and 4th and 12th October the carry in the 1st Anzac 
Corps was in certain places as much as 8,000 yards, as, for 
example, from the front line to the Birr cross-roads on the 
Ypres-Menin road. Plank roads had been laid down, but were 
so slippery that it was impossible to use even the horsed ambu- 
lance wagons on them. The advanced dressing station of the 
corps was on the Menin road, opposite the Ecole de Bienfaisance. 
From there light railways and tram lines were available. 

The Ilnd Anzac Corps had little difficulty in this respect in 
its first attack on the 4th October, but in the two subsequent 
assaults of the 9th and 12th October the battlefield had been 
converted into a sea of mud. Six bearers were required for 
each stretcher, and it took five hours on the 9th October to 
bring the wounded from a regimental aid post to an advanced 



158 MEDICAL HISTORY OF THE WAR 

dressing station. It was not possible to run special trains for 
them on the light railways, although in some cases trucks 
returning empty helped in bringing back sitting cases. Ambu- 
lance wagons and cars were frequently held up by traffic 
for an hour or more at a time. Notwithstanding these diffi- 
culties, most of the wounded were got back by night-time. 

The conditions on the 12th October were even worse. The 
stretcher bearers had to carry wounded a distance of 6,000 
yards, and it took seven hours to get the patients back 
to the advanced dressing station. A large number of infantry 
was detailed to assist in carrying them, and arrangements 
were made to collect them into such shelters as were 
available in the front line and supply them with food and 
blankets until it was possible to bring them back. In his 
observations on these conditions the D.D.M.S. of the corps, 
Colonel C. W. Begg, remarks that 600 fresh stretcher bearers 
were required on each divisional front every twelve hours, with 
a maximum of 300 stretchers and 1,000 blankets. The total 
casualties passing through his dressing stations between the 4th 
and 18th October were 362 officers and 11,243 other ranks, of 
whom 231 officers and 4,412 other ranks were stretcher cases. 
The numbers included 12 officers and 424 other ranks gassed. 

When the Canadian Corps relieved the Ilnd Anzac Corps 
on the 17th October and took over its medical posts, the stretcher 
bearers' work was considerably lightened by the laying of 
trench mats along the tracks. 

In the earlier phases of the battles this system of relay posts 
was not so much in evidence, and more use was being made 
of trolly lines. Thus the 20th Division (XlVth Corps), in the 
battle of the 16th-18th August, depended chiefly on a trolly 
line running to Fusilier Farm and the canal bank. The line was 
broken several times by shell-fire, but was speedily repaired. 
The division was given 200 infantrymen to assist the stretcher 
bearers. They were organized into four parties of one officer, 
two N.C.O.s and 47 other ranks each, and had been given a 
short training in first aid and bearer work for one week. The 
parties were used on relay posts, on the trolly lines, with 
wheeled stretchers, and as loading parties at entraining and 
detraining posts and at advanced dressing stations. 

Pack transport was used in some divisions for bringing 
material forward to advanced dressing stations and collecting 
posts in the later stages of the operations. The 25th Division, 
for example, when it was attached to the 1st Anzac Corps in 
September, had six pack horses allotted to each field ambulance. 



THE BATTLES OF YPRES, 1917 159 

The material, consisting of panniers, comforts, reserve dressings, 
rations, water, splints, sheets and blankets, directing flags, 
and other articles, was brought in limber wagons to Shrapnel 
Corner, south of Ypres, and there loaded on to the pack horses. 
But notwithstanding the difficulties in bringing the wounded 
back to the dressing stations, the general organization led to 
so rapid an evacuation that in one or two instances the 
casualty clearing stations were overwhelmed and the work of 
keeping them clear by means of ambulance trains was much 
delayed. This was specially so in the case of the clearing 
stations at Remy Siding on the first day of the battles. 
M ounded, both walking and lying down wounded, came there 
in large numbers, not only by motor ambulance convoy, 
charabancs, buses and lorries, but also in ambulance train 
coaches and empty trucks of supply trains. 

The Organization of Relay Posts. 

There were many examples of the organization of relay 
work by the stretcher bearers of individual divisions during 
the whole period of the battles. The number of relay posts 
varied according to circumstances, and the number of bearers 
in each according to the orders of individual A.Ds.M.S. As 
a rule the divisional or corps commander detailed 200 infantry- 
men under their own officers to assist the R.A.M.C. stretcher 
bearers ; and the regimental stretcher bearers were doubled. 
The relay posts were at distances of 500 to 800 yards from one 
another as a rule. In one division the number of stretcher 
squads at each post would be four, in another six. There was 
no definite rule. The bearers of No. 55 Field Ambulance of 
the 18th Division, for example, engaged in clearing regimental 
aid posts on the 12th October to Poelcappelle and back to Essex 
Farm, had a total carry of 4,500 yards, of which the last 1,500 
yards was on a trolly line from Minte Farm. Forty stretcher 
squads were used, with an average carry of 800 yards. They 
carried back 250 stretcher cases. Derelict tanks were useful 
as shelters for relay posts, especially at a point called Delta 
House, where there were four derelict tanks. 

The 9th Division, fighting on the right of the 55th Division 
on the 12th October, formed six relay posts from regimental 
aid posts at York Farm and Albatross Farm to cross-roads 
on the west of St. Julien, a distance of some 3,000 yards. There 
was an entraining point just south of St. Julien, and horsed 
ambulance wagons and Ford cars could come up to St. Julien ; 
but the larger cars could only work between California Farm 



160 MEDICAL HISTORY OF THE WAR 

and the advanced dressing station at Duhallow. Thirty-two 
bearers were posted at each relay, with 200 infantry men from 
the division in reserve. 

The Ilnd Anzac Corps formed four relay posts back to an 
advanced dressing station at Wieltje for the left division, 
and three for the right division to Frezenberg, where horsed 
ambulance wagons came up. The D.D.M.S. of the corps 
required 600 bearers, 250 from the field ambulances and 350 
from other units, as already noted. 

When the Canadian Corps took over its front it retained 
these two lines of relay posts ; but used a variety of means for 
getting the wounded back. In the operations of the 26th 
October hand carriage was used to Curve Farm, thence wheeled 
stretchers to Spree Farm, followed by another relay of hand 
carriage to Midland House, and from there to Wieltje by 
petrol tractors on tram lines. There were three or four relay 
posts to Frezenberg. From there motor ambulance cars were 
able to work on the 26th October. The corps had an advanced 
dressing station at Frezenberg, but a shell dropped on it on 
the 6th November, causing many casualties, six officers of 
the C.A.M.C. being killed and two wounded. Forty-four other 
ranks of the C.A.M.C. were also wounded. 

The Use of Ambulance and other Trains in the Front Area. 

Ambulance train coaches, belonging to No. 38 Ambulance 
Train, which had been constructed for use in the Macedonian 
theatre of war, were used on a broad-gauge railway between 
Ypres and Remy Siding.* 

The use of the broad-gauge trains to bring wounded back to 
Remy Siding was carried out under the orders of the Fifth 
Army Commander, as he was anxious to save the roads. 

On the 31st July the walking wounded who went to No. 3 
Canadian Casualty Clearing Station at Remy Siding came down 
in great numbers by these trains and very few by road. They 
consequently arrived in large batches, instead of coming down 
in small numbers at a time by lorries and charabancs. If 
the latter procedure had been carried out they would have 

* This ambulance train was not required in Macedonia ; it was accepted 
for France, and made its first trip on the 21st July 1917. The couplings, 
however, did not prove suitable to run with the ordinary French stock, and 
a breakdown occurred at St. Omer on the 18th August. The train was 
consequently put out of action on the 12th September 1917, and was then 
divided into two small trains to work in the front area until suitable steel 
wheels could be supplied to replace the wooden centre wheels of the coaches. 
These new wheels were fitted and the train returned to the ambulance train 
service on 23rd February 1918. 



THE BATTLES OF YPRES, 1917 161 

arrived at the casualty clearing stations earlier and been 
ready to fill the temporary ambulance train that was kept 
waiting there, but which had been delayed until the broad- 
gauge trains arrived from the front. The temporary ambulance 
train had been waiting at Remy Siding since 10 o'clock in the 
morning, and it took a long time before the large numbers 
arriving by the broad-gauge train could be got ready for 
entraining. The consequence was that the train did not leave 
until 2.30 in the afternoon. Further trouble arose from the 
fact that the empty supply trains bringing walking wounded 
cases from Vlamertinghe ran into the ambulance train siding 
at Remy, and by so doing prevented ambulance trains which 
were garaged down the line, coming up until the siding was 
clear. Consequently the congestion of the casualty clearing 
stations at Remy Siding on the night of the 31st July/ 1st 
August was excessive. The congestion could have been 
relieved by evacuating to Second Army casualty clearing 
stations at Godewaersvelde or to the hospitals at St. Omer 
by road. All available resources were placed at the disposal 
of the Fifth Army for this purpose by the D.G.M.S., but the 
D.M.S. of the army did not take advantage of them. Instead, 
he switched off the walking wounded from the XlXth Corps 
to the casualty clearing stations at Mendinghem. Fifty cars, 
however, were sent up to Remy Siding from St. Omer after 
midnight of the 31st July. They would have arrived earlier, 
but had to be employed in clearing patients to St. Omer from the 
medical units at Hazebrouck, which was being severely shelled 
in the afternoon and evening by long-range enemy artillery. 

Light railways were employed to bring wounded to Remy 
Siding from the advanced dressing stations at the Ecole de Bien- 
faisance on the Ypres-Menin road, and from those at Lock 8 
on the Canal and Woodcote House. Trains of four to eight 
trucks, carrying 80 or 180 cases, ran hourly, the average time 
taken on the journey from the Ypres-Menin road to Remy 
being one and a quarter hours. They were used chiefly by the 
Second Army after Remy Siding came under its control on 
the 20th September. The Second Army had then two other 
light railways with similar arrangements for evacuating 
wounded to La Clytte and Kemmel. The hourly service, 
however, broke down on account of damage to the line 
during the battle of Polygon Wood, on the 26th September, 
and only two full trains reached Remy Siding in consequence. 

In order to avoid congestion at Remy Siding on the 4th 
October the D.M.S. of the Second Army arranged that only 



162 MEDICAL HISTORY OF THE WAR 

half of No. 38 Ambulance Train should run from Ypres there 
with light cases of the 1st Anzac Corps and that the other half 
should run between Brandhoek and Godewaersvelde with the 
casualties of the Xth Corps, but eventually both sections of 
the train went to Godewaersvelde. In the attack on the 
16th October some of these coaches were run from Dickebusch 
to Bailleul ambulance train siding, the wounded being taken 
from there to the casualty clearing station at Oultersteene by 
road. On the 10th November, the trains also ran from 
Reigersberg to Mendinghem. These various lines of evacuation 
from forward areas to casualty clearing station centres are 
shown in the sketch maps. 

Shelling and Bombing of Medical Units. 

During the whole period of these battles medical units of all 
descriptions were constantly shelled or bombed by aircraft. 
The shelling of the casualty clearing stations at Brandhoek 
and the sites prepared at Elverdinghe has already been men- 
tioned. At Hazebrouck the office of the D.M.S., Second Army, 
and the medical units there, No. 15 CCS. and the New Zealand 
Stationary Hospital, had to move elsewhere when the town 
was shelled on the 1st August. One of the shells fell on No. 15 
CCS. and completely destroyed part of its camp, but for- 
tunately without causing casualties. The unit moved to 
Ebblinghem, half-way between Hazebrouck and St. Omer, 
and the New Zealand Stationary Hospital to Wisques, near 
St. Omer. 

The list of incidents on pages 163 and 164 represents approxi- 
mately the extent of enemy attacks at this period on medical 
units. They were of so exceptional a character as to give rise 
to the belief that they were deliberate. The medical units 
were indicated by the usual red cross signs on roofs of huts, and 
also on large squares on the ground such as could be seen 
by aircraft. The positions of casualty clearing stations had 
also been notified to the enemy. 

A photograph taken from the air appeared in a German illus- 
trated magazine " Die Woche " on the 4th August showing a 
British observation balloon moored near a medical unit and near 
the sign of the Red Cross belonging to the unit. The illustration 
drew the attention of the reader to the assumption that the 
Red Cross had been placed there to protect a balloon which 
was used in directing artillery fire. The photograph was sent 
by the General Staff to the D.D.G.M.S., who identified it as 
a photograph of the main dressing station of the XVIIIth 



THE BATTLES OF YPRES, 1917 



163 



List of attacks on medical units of Second and Fifth Armies 
July to November, 1917. 



Date. 


Unit attacked. 


Locality. 


Remarks. 


3rd/4th July 


No. 1 Australian 


Bailleul . . 


One bomb, killing a 




CCS. 




nursing sister. 


6th/7th July 


No. 11 CCS. 


Bailleul Am- 


Air raid 2.30 a.m. 






bulance 


Clear night. Airmen 






Siding. 


flew low. Dropped 
7 bombs. Four 
R.A.M.C. and 23 
patients killed. Five 
R.A.M.C, the chap- 
lain and 63 patients 
wounded. 


13/14th July 


No. 15 CCS. 


Hazebrouck 


Three bombs. No 
casualties. 


22nd July . . 


No. 64 CCS. 


Mendinghem 


Four bombs 11 p.m. 
No casualties. 


22nd/23rdjuly 


No. 2 Australian 


Trois Arbres 


Two A.A.M.C and 




CCS. 




2 patients killed. 
Twenty patients 
wounded. Four 
bombs. Also shelled. 


31st July . . 


No. 46 Field Ambu- 


Brandhoek 


Shelled morning of 31st 




lance. 




July, and on and off 




M.D.S. XlXth Corps. 




since 19th June. 


5th August . . 


XVIIIthCorpsM.D.S. 


Gwalia Farm 


Shelled. Two R.A.M.C 




lst/2nd Highland 




and 1 A.S.C killed, 




Field Ambulance. 




25 other ranks 
wounded. This was 
the day following the 
date of illustration in 
" Die Woche." The 
shelling was delib- 
erate. 


16th August 


No. 3 Australian 


Brandhoek 


Bomb 10 p.m. One 




CCS. 




medical officer and 
1 orderly A.A.M.C 
killed. 


17th August 


No. 17 CCS. 


Remy Siding 


Four bombs. 9.20 p.m. 
Casualties — 

Killed. Wounded. 

R.A.M.C. 6 13 

Fatigue men7 15 

Officers' ser- 
vants 1 5 

German 

patients 13 6 

No officer casualties. 


17th August" 






Bombed 9.30 to 10.30 
p.m. from 300 to 400 
ft. Two officers and 


' 


No. 61 CCS. 


Dozinghem< 


3 sisters wounded, 1 
other rank killed and 
3 wounded. 


20th August 






Four patients killed 






^ 


and 18 wounded. 



164 



MEDICAL HISTORY OF THE WAR 



Date. 


Unit attacked. 


Locality. 


Remarks. 


15th August" 






Four officers and 4 
other ranks wounded 


17th August 






on the 17th, and 1 


> 


No. 4 CCS. 


Dozinghem - 


officer, 1 "sister, and 


19th August 






28 other ranks on the 
20th ; 6 other ranks 


20th August 






killed on the 20th. 


20th August 


No. 47 CCS. 


Dozinghem 


Fourteen other ranks 
killed. Seven officers, 
2 sisters, and 45 other 
ranks wounded. 


21st August 


No. 44 CCS. 


Brandhoek 


Shelled all day. One 
sister killed. Two 
other ranks wound- 
ed. 


29th August" 






Heavily shelled. Mar- 
quees in course of 


► 


No. 10 CCS. 


Elverdinghe* 


erection riddled with 
shrapnel. Red Cross 
frames on ground. 


31st August 






One man wounded. 


29th Sept. 


No. 32 CCS. 


Brandhoek 


Bombs. No casualties. 
Ten marquees des- 
troyed. 


1st October. . 


No. 4 Stationary 


Arques 


Bombed. Four killed 




Hospital. 




and 5 wounded. Den- 
tal centre destroyed. 


20th October 


Nos. 37and41C.C.Ss. 


Godewaers- 


Bombed. One sister 






velde. 


killed. Seven patients 
and 8 R.A.M.C 
wounded. 


29th October 


No. 61 CCS. 


Dozinghem 


Bombed 11.30 p.m. 
One sister wounded, 
3 patients killed. 
Three patients and 
1 R.A.M.C. wounded. 



Corps at Gwalia Farm, long after the balloon had left the 
vicinity of the dressing station, so that the photograph had 
probably been taken before the series of attacks on the medical 
units, and had no doubt been published in explanation of these 
attacks at a later date. At least such was the conclusion 
drawn from this unusual action on the part of the enemy. 

The increasing frequency with which casualty clearing 
stations were being shelled and bombed led to a memorandum 
being issued to armies by the General Staff at the beginning 
of August. The attention of Army Commanders was directed 
in this memorandum to the fact that a tendency existed to 
site casualty clearing stations too far forward, and pointed 
out that the most forward of these stations should always be 



THE BATTLES OF YPRES, 1917 165 

well in rear of the balloon line, and as far away as possible 
from ammunition dumps, aerodromes, railheads, or other 
targets likely to draw the enemy's fire. 

Provision for the Treatment of Wounds during the Battles. 

A special feature of the work of the medical services during 
these battles was the provision that had been made for the 
surgical treatment of wounds in casualty clearing stations. 
For this purpose the number of surgical teams and other 
personnel sent to the Fifth Army was greatly in excess of 
what had been possible during previous battles. A conference 
was held by the D.G.M.S. on the 23rd June, in which the 
D.D.G. discussed with the Ds.M.S. of Armies and of the 
L. of C, and the D.D.M.S., XVth Corps, the general arrange- 
ments for the forthcoming operations, especially with regard to 
the additional surgical teams, for whom provision had been made 
by the maintenance of reserve operating sets to enable three 
extra operating tables being worked in each of twelve casualty 
clearing stations. These sets were held in the base depot of 
medical stores at Boulogne, and were supplemented by surgical 
cloaks, sheets, and other operating-room equipment in twelve 
sets maintained for the purpose, at the request of the D.G.M.S., 
by the Red Cross Advanced Stores at Ham-en-Artois near 
Lillers. 

On the 17th Jury, the D.G.M.S. had arranged for 15 surgical 
teams and 100 R.A.M.C. other ranks to go to the Fifth Army 
from the First Army, 10 surgical teams and 100 other ranks 
from the Second Army, and 25 surgical teams and 200 other 
ranks from the Third Army, in addition to 32 surgical teams 
from hospitals on the L. of C. Subsequent orders, however, 
restricted these numbers considerably, and the position on 
the 1st August was that the Fifth Army had, in addition to its 
own medical personnel, 57 surgical teams (25 from the Third 
Army and 32 from the L. of C), 40 additional medical officers 
(18 from the First Army, 14 from the Third Army, 2 from 
No. 20 Field Ambulance, G.H.Q., 4 from No. 59 C.C.S., 
G.H.Q., and 2 from the L. of C), and 275 other ranks 
R.A.M.C. (200 from the Third Army, 50 from No. 20 Field 
Ambulance, and 25 from No. 59 C.C.S.). 

These numbers varied from time to time during the battles, 

but they represented more or less the proportion of additional 

t surgical assistance sent to the casualty clearing stations engaged. 

In the final phases of the battles of Ypres the additional 
personnel in casualty clearing stations consisted of 46 surgical 



166 



MEDICAL HISTORY OF THE WAR 



teams, 21 additional medical officers, and 195 other ranks 
of the R.A.M.C. in the Second Army ; and 28 surgical 
teams, 15 additional medical officers, and 140 other ranks 
R.A.M.C. in the Fifth Army. 

The accommodation in the Fifth Army casualty clearing 
stations was expanded to provide for 1,000 casualties in each. 
Consequently a very large number of huts and tent age, as 
shown in the following table, was provided : — 

Number of tents and huts in casualty clearing stations of the Fifth Army 

during the battles of Ypres, 1917. 
Hospital marquees — 

Large 

Small single 

Small new pattern 

E.P.I.P 

Canadian pattern 

Hospital small double 

Hospital large I. P. 
Ward huts 

Bell tents 

Ocher tents. . 
Other huts 



32 

261 

686 

28 

21 

720 

6 



1,754 



94 
720 

88 
145 



Large numbers of stretchers and blankets were also sent to 
the armies engaged, in fact, during the year 1917, the ambulance 
trains delivered to units in army areas 17,835 stretchers, as 
follows : — 

Stretchers supplied to Armies in 1917. 







396 






551 


March 




1,290 


April 




3,807 


May- 




186 


June 




1,507 


July 




1,908 


August 




1,638 


September 




2,168 


October 




2,234 


November 




1,050 


December 




1,100 


Total 


17,835 



What became of the enormous number of stretchers sent 
up to armies was at all times a mystery to those whose duty 
it was to endeavour to recover them. 

In addition large numbers of stretchers were held in army 
dumps ; in fact by the end of the year the Second Army in the 
Ypres area had a reserve of 19,443 stretchers in the casualty 
clearing stations and in the six corps of which the army was 
then composed. 



THE BATTLES OF YPRES, 1917 



167 



Large reserves of blankets and stretchers were also held at 
No. 4 Stationary Hospital, Arques, for delivery to army areas. 
The reserve consisted of 2,300 stretchers and 6,000 blankets. 
This reserve had been established at St. Omer in 1915, and 
had been maintained ever since, but it was decided in the 
middle of September 1917, that it would be no longer necessary 
to maintain the reserve there. Steps were subsequently taken 
by the D.G.M.S. to hold a large reserve in the casualty clearing 
station at Hesdin, under his own control. 

The Surgical Results. 

It is interesting to compare the resources placed at the 
disposal of the Fifth Army with the resources placed at the 
disposal of other armies during previous battles, and also the 
surgical results. They are shown in the following tables. 

In order to compare surgical results, enquiry was made by the 
D. D.G.M.S. as to the deaths amongst wounded in the hospitals 
on the L. of C, who were received from the Second Army 
during the first week of the battle of Messines, 7th to 13th June, 
and from the Fifth Army during the first week of the Ypres 
battles of 1917, 31st July to 6th August. The results were 
as follows : — 

Comparative Results of Wound Treatment in Second and Fifth 
Armies, during the first week of Messines and Ypres Battles, 1917. 





Second 


Army, 


Fifth 


Army, 




Messines, 


Ypres 


Battle, 




7.6.17 to 13.6.17. 


31.7.17 to 6.8.17. 


No. of wounded admitted to C.C.Ss. 




18,492 




21,733 


No. of deaths in C.C.Ss. 




629 




817 


No. received in L. of C. hospitals 




16,290 




16,768 


No. of deaths in L. of C. hospitals 




162 




177 


No. of deaths on ambulance trains 




13 




4 


No. of C.C.Ss. employed 




15 




15 


No. of M.Os. employed : — 










(a) from the army 


116 




110 




(b) from other sources . . 


100 




179 




(c) Total 





216 





289 


Sisters employed 




259 




405 


Other ranks employed : — 










(a) Own army . . 


1,342 




1,173 




(b) Other sources 


443 




1,389 




(c) Total 





1,785 





2,562 


X-ray outfits 




8 




9 


Percentage of deaths to wounds : — 










(a) In C.C.Ss 




3-4 




3-7 


(b) In Base Hospitals . . 




0-9 




1-0 


(c) Total deaths from wounds 












admitted 




4-3 




4-6 


Percentage of M.Os. to the number 










of wounded admitted to the 










C.C.Ss 




1-16 




1-86 



(10134) 



168 



MEDICAL HISTORY OF THE WAR 



-to 

CO 

s 

o 

ft 



8 

O 

-S 

CO 

8P 
Is 



to 



ft* 



•3[39AV }SJIJ 'SJJITBJ 














jaq^o "oi'VH 


O CD 

co m 


CO 


CO 
CO 


o 


o 
o 


l> 


'sgppms-eo jo o^ 




,— ' 


CO 


CN 


CN 


CO 


•3[99AV ^SJljt 'S'Ol 


CD o 


„ 


t^ 


CD 






'S9I^fBnS'B0 JO "O^ 


~ 


CO 


"* 


CN 


CN 


rf 


















sS- 


Vi 










•J[99AV }SJIJ 




' ' 










Suunp pg^iiup-e 


00 CO 


CN 


CN 


CN CD 
"«* CD 


CN 

CD 


m CO 
O CO 


pgpunoM jo -o^i 


«■* CO 


<tt 


CN 


CO CD 


««* 


CD C^ 




oo~ co" 


Tf 


CN 


in co" 


co 


co" i-T 






CN 


rr 


CN 




CN 


X«j-x jo -ojs[ 


1 1 


CN 


CD 


CN CO 


00 


t> CD 


1 1 












£o 




lO m 


<* 


CD 


CN CD 


CO 


CD CD 


r° 


CN 


CD 


CO 


CO 00 


Tf 

^ 


CO 00 


o . 














, ~ | 


•sjg^sxg 


CO 00 


1 


t^ 


co oo 


00 


CD IN 


jo o N 




1 




CN i-i 


J^ 


CN 


















si en 

So 


oo i% 


t^ 


o 


in m 


o 


CO CD 


£s 






CN 


— i CO 


o 


y— tr> 














"* 






I ; 




, ^ 












«a 




^3 


























ofcJS 


t^ CM 


»-h 


m 


co in 


CN 


CD CO 


>> 


« .3 d 


in 00 


CO 


CD 


co o> 


""f 


CD I> 


a 

o 

a 

2 




T lO 


1-H 


co 


CN ^ 


co__ 


CD r^ 


•SJ9^STS 


CD 05 


m 


© 


CD Tf 




r-< CO 


jo -qn 


CN CO 


i> 


CO 


Oi I> 


N< 


CD CN 


HH (/i 














fe 


°d 


co m 


_» 


Tf 


o «<* 


CD 


t^ O 




Ojj 


Tf m 


CD 


m 


O CN 


y—l 


t>. T-. 




££ 






*" H 


T-H l-H 


'"' 


** 


•p9Ao{dlU9 


t> r^ 


CN 


CO 


r-* CO 


m 


cd m 


'SS'O^O P o N 














CO T3 


• T3 




A 




T3 


T3 • 


1/ CJ 


2 8 


co 
u 


tJ 

o 




o 


§ 5 

O "3 


<§ 


fe CO 


& 


Ph 


Uh h 


CD 


CO fo 


•8 

CD 


in ^ 


to »-< 




• CD 

^ o^ # 
oj "^ ci 


sf 3 


-J QJ 




1—1 


<U 3 < 


Pu 


fill 




o 


»— i to CD 




O <N 


m 


to 




■4-> 






rl CN 


CN 




05 


t^ 


CO 




<D 






o to 


: 


to 




d3 






W) ^ 




4J 


6 




(1) 


•2 fc 


to 
o 


n 




pq 


S? d to 

> rt 0) 

55 |H 


to 
O 


a 

a 

o 
en 


|1 

> 


.s 

'co 
to 
<u 


to 



THE BATTLES OF YPRES, 1917 



169 



The percentage of deaths amongst wounded on the L. of C. 
was therefore practically 1 per cent, amongst those from the 
Second Army, against 1-05 per cent, amongst those from the 
Fifth Army, but the deaths on the ambulance trains were 
about three times less in the battles of Ypres than in the battle 
of Messines Ridge. 

As regards surgical operations the following table shows the 
number of wounded admitted into casualty clearing stations 
of the Second and Fifth Armies between the 31st July and 
16th November, 1917, with the numbers operated on in them. 

Statistics of the number of wounded on whom operations were 
performed in the Casualty Clearing Stations of the Second 
and Fifth Armies between 3lstjuly and 16th November 1917. 



Casualty Clearing Stations. 


Number 
admitted. 


Number 
operat edon. 

6,016 
4,673 
5,002 
5,816 


Percentage 
operated on. 


Remy Siding Group — 
No. 2 Canadian 
No. 3 Canadian 

No. 10 

No. 17 


20.497 
18,721 
17,343 
17.361 


29-6 
25-0 
29-0 
30-2 


Nine Elms Group* — 
No. 3 Australian 
No. 44 


7,073 
8,234 


2,107 
2,377 


30-0 
29-0 


Brandhoek — 

No. 32 


5,349 


1,253 


23-9 


Godewaersvelde Group — 
No. 37 . . . . 

No. 11 

No. 41 


6.572 
6,883 
6,823 


1,373 
2,000 
2,028 


22-5 
30-5 
30-0 


Bailleul Group — - 

No. 2 

No. 53 

No. 1 Australian 
No. 2 Australian 


3.267 
5.026 
4,011 
3,167 


878 
1,212 
2,111 
1,474 


29-0 
40-0 
51-0 
46-0 


Dozinghem Group — 

No. 4 

No. 47 

No. 61 


11,447 
12,233 
10,932 


3,811 

4,464 
4,183 


35-0' 
36-0 
38-0 


Mendinghem Group — 

No. 12 

No. 64 

No. 46 


13,109 
11,179 
12,637 


3,603 
3,490 
3,552 


28-0 
30-0 
27-5 



* At Brandhoek during August. 



170 MEDICAL HISTORY OF THE WAR 

It will be observed that in casualty clearing stations receiving 
comparatively small numbers of wounded the percentage of 
operations was naturally very much higher than in those 
receiving large numbers of wounded ; the greatest percentage 
of operations being 51-0 in No. 1 Australian CCS. of the 
Bailleul group, out of 4,011 admissions, and the smallest 25-0 
per cent, in No. 3 (Canadian) CCS., out of 18,721 admissions, 
although it ought to be stated that the majority of admissions 
into No. 3 (Canadian) were walking wounded cases and there- 
fore not requiring the same extent of operative interference. 
In the hospitals specially detailed for seriously wounded, such 
as No. 4 at Dozinghem, the comparatively high number of 
35 per cent, was operated upon out of 11,447 admissions, but 
No. 32 CCS. at Brandhoek, which received severely wounded, 
had the small percentage of 23 -9 per cent, out of 5,349 admiss- 
ions, although it must be noted that after August 21st this 
casualty clearing station was receiving walking wounded only. 

The total number wounded and the number of operations, 
to which these figures refer, were 199,864 wounded and 61,225 
operations, or 30-6 operations amongst every 100 wounded 
admitted. The operations included all operations undertaken 
for cleansing of wounds and excising damaged tissues, in 
slightly wounded as well as in the more severely wounded. 

The Mustard Gas Attack. 
In addition to the wounded, numbers of cases injured by 
mustard gas came to the casualty clearing stations. The 
first mustard gas attack took place in the Ypres area on the 
night of the 12th/13th July after a heavy bombardment, 1,800 
cases being admitted to the casualty clearing stations on the 
13th July. Large numbers of gassed cases were again admitted 
on the 11th and 12th September, and on the 17th October it 
was stated that one- third of the casualties occurring at that 
time were due to gas, and that the case mortality was higher. 

Analysis of Nature of Wounds. 
An attempt was made during these battles to analyse the 
nature of the wounds admitted during twenty-four hours on 
the 21st and the 27th September, with the following results : — 

Among 10,789 British wounded on the 21st September — 
77 were hand grenade wounds. 
17 bayonet wounds. 
2,933 bullet wounds. 
2,142 shrapnel wounds. 
3,867 high explosive shell wounds. 

209 gassed. 
1,544 uncertain causes. 



THE BATTLES OF YPRES, 1917 171 

Among 756 German wounded — 
264 were bullet wounds. 
363 shell wounds. 
120 uncertain causes. 
9 gassed. 
On the 27th September, of 2,932 British wounded admitted in the 
twenty-four hours : — 

16 were hand grenade wounds. 
8 bayonet wounds. 
600 bullet wounds. 
836 shrapnel wounds. 
1,325 high explosive shell wounds. 
106 gassed. 
41 uncertain causes. 
and of 88 German wounded — 
22 were bullet wounds. 
52 shell wounds. 
2 gassed. 
12 uncertain causes. 

Sickness during the Battles. 

The sickness during the period of the battles was com- 
paratively slight. Most of the patients were treated in 
divisional or corps rest stations, although an average of 0-3 to 
1*0 per cent, of strength had to be evacuated weekly to the 
base. The wastage from sickness was thus considerably less 
than wastage from wounds. In the Fifth Army, for example, 
the records show that 1,805 officers and 40,899 other ranks 
were sent to the base sick, as compared with 4,159 officers and 
100,688 other ranks wounded between the 1st July and the 
10th November 1917. 



CHAPTER IX. 

THE BATTLE OF HILL 70, AUGUST 1917. 

The Battle of Hill 70 was fought between the 15th and 
25th August, 1917, by the 2nd and 1st Canadian Divisions 
of the Canadian Corps in the First Army area, and resulted in 
the capture of Hill 70, which had been reached but not held 
in the Battle of Loos, and also the mining suburbs on the 
outskirts of Lens. The fighting was of an exceptionally severe 
character, and the casualties were heavy, especially from 
mustard gas. 

The 2nd Canadian Division medical services were directed 
by the A.D.M.S., Colonel H. M. Jacques, who had established 
a main dressing station with No. 4 Canadian Field Ambulance 
under Major Macdonald at Fosse 10, and a main dressing 
station for walking wounded by No. 6 Canadian Field Am- 
bulance under Lieut. -Colonel Murphy at Aix-Noulette. There 
were both a narrow-gauge and a broad-gauge railway running 
up towards the positions from which the attack was launched, 
and an advanced dressing station was placed at each railhead, 
relays of bearers bringing the wounded back from the regi- 
mental aid posts to these positions. From the advanced dressing 
stations both sitting and stretcher cases went back by rail 
to Fosse 11, chiefly by the narrow-gauge railway, and from 
there the stretcher cases were taken by motor ambulance 
cars to the main dressing station at Fosse 10, and the walking 
wounded by the narrow-gauge railway to Aix-Noulette. The 
assistance afforded by the use of this line was so great that 
it became unnecessary to use lorries or other vehicles for the 
conveyance of the walking wounded. The plan of evacuation 
worked throughout smoothly and without hitch, and no delay 
or congestion occurred at any point. No. 8 M.A.C. and 
fifteen motor lorries were employed in evacuating from the 
main dressing stations to No. 22 CCS. at Bruay. 

The 2nd Canadian Division was again engaged on the 21st 
August, when the arrangements were of a similar nature and 
worked equally well. Casualties during this attack were 
heavier, over 700 being admitted to the main dressing station 
at Fosse 10, and about eighty to Aix-Noulette. 



THE BATTLE OF HILL 70, AUGUST 1917 173 

The 1st Canadian Division (Colonel Wright, A.D.M.S.) 
had relieved the 6th Division before the attack and taken 
over the field ambulance posts established by it. Much work 
had been done by the latter division in preparing advanced 
dressing stations and regimental aid posts in and around Loos, 
Maroc, Philosophe and the forward area in deep dugouts and 
cellars, which were well protected, conveniently placed and 
capable of accommodating over 500 stretcher cases. The 
main dressing station was situated in a school at Noeux-les- 
Mines, where there was spacious and well-planned accommo- 
dation for receiving and treating large numbers of wounded 
The walking wounded dressing station was at Barlin. 
Each battalion on going into the line was furnished with 
twenty-five stretchers and a box of medical comforts supplied 
by the Canadian Red Cross Society. The clearing from the 
regimental aid posts was carried out by two of the field am- 
bulances, augmented by bearers of the third field ambulance. 
One hundred extra bearers were also detailed from each of the 
two attacking brigades to assist in bringing wounded to the 
advanced dressing stations, and men of the pioneer battalion 
also helped in carrying the wounded. Roads leading to the 
front were in such good condition and had escaped destructive 
shell-fire to such an extent that the motor ambulance cars 
were able to run into the most advanced stations, greatly 
relieving the work of the bearers. There was a tram-line, 
but it had been destroyed and was of little use. 

On the night of the 17th/ 18th August, the enemy heavily 
bombarded the 1st Canadian Division area with gas shells, 
and rendered the work of clearing the wounded very difficult, 
as well as causing many casualties amongst the bearers. As 
soon as it was ascertained that mustard gas shells were being 
thrown prompt measures were instituted at the advanced 
dressing stations to combat their effects. The patients were 
stripped in the open air and then brought into the advanced 
dressing station, where they were bathed from head to foot in 
soda solution, their eyes washed with the solution (one per cent.), 
and covered with gauze, and each patient given thirty grains 
of soda bicarbonate internally. The patients were then 
dressed in pyjamas and evacuated as stretcher cases. Only 
a few required inhalation of oxygen. The value of this early 
treatment was shown by the good condition in which the 
patients arrived at the casualty clearing stations. 

No. 12 M.A.C. cleared from the main dressing station to the 
casualty clearing stations, the severely wounded going to 



174 MEDICAL HISTORY OF THE WAR 

No. 7 C.C.S., then established at Bracquemont, a suburb of 
Noeux-les-Mines. The walking wounded were sent to No. 22 
CCS. at Bruay in lorries. 

As Maroc and its vicinity were heavily shelled on the first 
day of the attack, the advanced dressing station there was 
not used, and evacuation took place chiefly through the ad- 
vanced dressing station at Philosophe. 

The casualties in the 1st Canadian Division were heavy. 
From the commencement of the attack on the night of 
17th/18th August up to 5 p.m., on the 18th August, 75 
officers and 2,546 other ranks had been admitted to its field 
ambulances, in addition to 8 German officers and 249 German 
other ranks, and during the succeeding night 8 officers and 
390 other ranks had been collected and casualties were still 
coming in. 

The operations of the 1st and 2nd Canadian Divisions were 
carried out to relieve pressure against the British in the Ypres 
salient, and were conducted against a much superior force of 
the enemy, thus explaining the heavy casualty list. 



CHAPTER X. 

THE DUNKIRK-NIEUPORT AREA, 1917. 

THE front line of the coast sector taken over from the French 
by the XVth Corps on the 11th June, 1917, extended from 
the sea to St. Georges on the Yser Canal. The line from the sea 
was on the right bank of the canal near Lombartzyde, and 
then crossed it to St. Georges, which was on the left bank. 
At the time when the area was taken over, two divisions, the 
32nd on the right and the 1st on the left, occupied this line, 
with the 66th Division in reserve. 

The area consisted of two zones of country, dunes and 
sandy beach on the north, and fiat ground intersected with 
canals, drains or dykes on the south. The town of Nieuport 
was practically in the front line. The evacuation of wounded 
from the area was difficult, as many of the roads were much 
exposed to fire and direct observation. Carries by bearers 
were long and tedious, especially through the dunes and 
sands, and relays had to be arranged. Walking wounded 
on the left sector, however, could make their way back on 
the firm sands of the coast. 

The front line covered a distance of some four miles. Along 
it seven regimental aid posts of varying capacity were 
established, some sheltering six and others as many as twenty 
stretcher cases. The aid posts were capable of withstanding 
any artillery fire except a direct hit by a large shell, and were 
completely protected against gas. There were two collecting 
posts, both on the right sector close to the regimental aid 
posts. A bearer sub-division of a field ambulance was posted 
to each. 

There were three advanced dressing stations, so placed that 
they could be accessible by cars. They were all in extensive 
cellars capable of withstanding direct hits by 8-in. shells, 
two of them on the left sector at Nieuport Bains and Oost 
Dunkirk Brewery, with a total capacity for 250 stretcher 
cases, and the third at Nieuport, for sixty stretcher cases. 
The last had electric light and an electric fan, and all were 
fully protected against gas. Dugouts in the dunes on the 
coast near Groenendijk Plage were used as collecting posts. 



176 MEDICAL HISTORY OF THE WAR 

There were three walking wounded collecting stations. 
Two were for the left sector at Oost Dunkirk Bains and Oost 
Dunkirk Town, each serving a different route of evacuation. 
The third was for the right sector and was two miles outside 
Nieuport on the main Nieuport-Coxyde road. The routes of 
evacuation from the left sector were by the coast route, and 
by a Decauville line running along an inland road to Coxyde. 
The right sector had three routes of evacuation from Nieuport 
to the Oost Dunkirk road, one via Triangular Wood, another 
via Piste des Zouaves, and the third via Pelican Bridge and 
Wulpen Bridge. A Decauville line ran along all these roads, 
and all lines of evacuation joined up at the Oost * Dunkirk- 
Coxyde road, whence the route was to the corps main dressing 
station. Wheeled stretchers were used to bring wounded to 
the advanced dressing stations. 

The D.D.M.S. of the XVth Corps, Colonel Newland, on 
arrival in the area formed a corps main dressing station at 
De Groote Kwinte Farm, where there had previously been a 
French medical unit, on the road between Furnes and Coxyde. 
It was opened on the 18th June. This corps main dressing 
station was seven miles from the front line, and had ten Adrian 
huts and a large number of hospital marquees. It also 
had a large operating theatre, and was eventually equipped 
to receive 1,200 at one time, special arrangements being made 
in it for gassed cases. The more serious cases amongst the 
wounded went direct, however, to the casualty clearing 
stations. A complete field ambulance formed the personnel 
of the corps main dressing station. 

Only two casualty clearing stations, No. 1 Canadian and 
No. 24, went with the XVth Corps to the coast area. They 
were opened at Oosthoek, near Adinkerke, where there had 
been a hutted hospital presented to the French and maintained 
by an American lady, Mrs. Turner. The hospital had 16 huts 
in all, 8 of which were ward huts for 18 beds each. They were 
taken over by No. 1 Canadian Casualty Clearing Station, 
British huts and tentage being added* No. 24 was opened 
some time afterwards near No. 1 Canadian at Oosthoek in 
Nissen huts. 

When Surg.-General O'Keeffe arrived with the Fourth Army 
Headquarters, three more casualty clearing stations were 
brought up, Nos. 36, 39, and 34. No. 36 was opened in a 
portion of a large sanatorium on the coast at Zuydcoote, the 

* Mrs. Turner followed the French troops to Roosbrugge, where Nissen 
huts were given to her in exchange for those left at Oosthoek. 






THE DUNKIRK-NIEUPORT AREA, 1917 177 

greater part of the building being retained as a hospital by 
the French. No. 39 was established in tents at Oosthoek 
and opened at the beginning of August, at the same time as 
No. 24, the huts for which were not ready until then. No. 34 
did not arrive in the area until later. It was sent at first to 
St. Idesbald, on the coast about one and a half miles north- 
east of La Panne, for the reception of infectious cases and 
nerve cases (N.Y.D.N.). There was an admirably equipped 
Belgian Isolation Hospital already there in ten pavilions and 
huts, and the intention was to take these over. 

The site of the three casualty clearing stations at Oosthoek 
was on flat low-lying ground liable to become very wet, and 
the huts were consequently well raised on piles off the ground, 
and roads and duck-board paths were made. There was a good 
ambulance train siding at Oosthoek, sufficient to garage, if 
necessary, two ambulance trains. The accommodation in 
each of these three casualty clearing stations was approximately 
1,000. No. 36 C.C.S., at Zuydcoote, could also accommodate 
1,000 and St. Idesbald Hospital 200, or with the addition of 
tents 750. St. Idesbald, however, was too far forward. No. 34 
C.C.S., which arrived there in August, was consequently 
closed, owing to danger from artillery fire, before any patients 
had been admitted, and was eventually opened in tents 
outside the Zuydcoote sanatorium on the 26th August. 

Dr. Depage's Belgian hospital at La Panne, the " Ambulance 
Ocean," and the Society of Friends' Queen Alexandra Hospital 
of 160 beds at Malo-les-Bains, placed beds at the disposal of the 
British. These were hospitals for the Belgians, but the latter, 
which had an agreement with the B.R.C.S. of the 29th July, 
1915, had been under the administration of the D.M.S., 
L. of C, for the reception also of sick from British labour corps 
at the Dunkirk port. Serious wounds of the head, chest, and 
abdomen were, by arrangement with Dr. Depage, sent to his 
hospital on payment of three francs for each patient daily. 

A large corps rest station to accommodate about 2,000 was 
established by the XVth Corps, near Zuydcoote. 

There was thus ample accommodation for the sick and 
wounded of the area provided there was adequate means of 
evacuation. Evacuation was possible by road or canal to 
St. Omer and Calais as well as by ambulance trains. Surg.- 
General O'Keeffe's estimate of maximum requirements for 
evacuation by these three routes was six ambulance trains, 
carrying a total of 4,000, two motor ambulance convoys 
making two journeys daily to St. Omer or Calais, carrying a 



178 MEDICAL HISTORY OF THE WAR 

total of 1,200, thirty charabancs carrying 800 sitting cases, 
and 12 ambulance baLges, carrying 360 lying cases. This 
estimate was made on the assumption that the number of 
wounded on the first day of an active offensive on the coast 
front would amount to 10,000, and on the second day 5,000. 

Two motor ambulance convoys, No. 26 and No. 10, and 
three ambulance flotillas, Nos. 3, 4, and 5, were allotted to him, 
No. 3 having been brought up from the Somme to Calais on the 
29th July. Nos. 4 and 5 arrived at Dunkirk and Adinkerke 
on the 19th July, The barges took twelve hours to reach 
St. Omer, the distance from Adinkerke to Dunkirk being 
about twelve and a half miles and that from Dunkirk to 
St. Omer through Bergues and Watten thirty-five and a 
half miles. 

Other medical units in the Dunkirk area were two mobile 
laboratories (No. 12 Hygiene and No. 19 Bacteriological), 
an advanced depot of medical stores, No. 13, a mobile X-ray 
unit, and a mobile dental unit. They were all at Malo-les-Bains 
except the bacteriological laboratory and X-ray unit, which 
were placed at Oosthoek and Zuydcoote respectively. There 
were also three sanitary sections. 

Medical arrangements for British Artillery with the 
Belgians. 
Certain British artillery units were attached to the Belgian 
Army in the Dixmude front, and when the British held the 
coast sector a section of a field ambulance was detached for 
duty with it. The arrangements were that the sick and 
wounded of the artillery would be collected to an advanced 
dressing station and collecting post opened by it and trans- 
ferred to the casualty clearing stations in the British coast 
area. Six motor ambulance cars were attached to it for 
bringing sick and wounded from the artillery aid posts, 
seventeen of which were formed by officers in medical charge 
of brigades of artillery and groups of heavy artillery. Five 
of the posts were reinforced by additional R.A.M.C. personnel 
and were provided with wheeled stretchers. They were in 
telephone communication with the group of motor ambulance 
cars. The advanced dressing station was at Avecappelle on the 
Dixmude-Furnes road, with a personnel of two medical 
officers and bearer squads and with four motor ambulance cars. 
The collecting post was established at Zotenay, also on the 
Dixmude-Furnes road, with one medical officer, bearer squads 
and two motor ambulance cars. 



THE DUNKIRK-NIEUPORT AREA, 1917 179 

In response to a telephone or other message stating the 
number and particulars of casualties requiring to be removed, 
motor ambulance cars were to be sent from the XVth Corps 
main dressing station to remove sick and wounded to it. 
Arrangements had also been made with the Belgian authorities 
for casualties amongst British troops being received into 
Belgian dressing stations and Belgian casualties into the 
Biitish dressing stations, according to circumstances. 

Medical Work during operations in the Coast area. 

Although no active operations of any magnitude were 
undertaken by the Fourth Army and XVth Corps on the 
coast, the narrow strip of country occupied by the British 
was constantly shelled and bombed and subjected to gas 
attacks. In addition, the enemy launched a determined 
offensive against the British front on the 10th July. The 
attack began at 7-45 in the evening after a heavy bombard- 
ment, and the 1st Division, holding the left sector, was driven 
back over the Yser Canal, two of its battalions being wiped 
out. Two R.A.M.C. officers of the division were missing, 
Captains Ward and Hayes. The 32nd Division, which was 
at first also driven back, held out. All the bridges between 
Nieuport and the sea were destroyed by the preliminary 
bombardment, and great difficulty was experienced in bringing 
cases back, in fact very few casualties were cleared from that 
portion of the front ; but Captain H. A. Pallant, the officer 
in medical charge of the 1st Battalion of the Loyal North 
Lancashire Regiment, did good work in swimming the Yser 
and assisting back men who could not swim. 

The total number of casualties admitted to the medical units 
during this attack up to the 12th July was 39 officers and 
1,247 other ranks, of whom 21 officers and 741 other ranks 
were from the 32nd Division, and 13 officers and 222 other 
ranks from the 1st Division, the remainder coming from army 
and corps troops. 

The enemy attack was not continued after the 12th July, 
but back areas were constantly shelled and bombed. 

The advanced dressing station of the 32nd Division received 
three direct hits, one from a 12-in. shell which wrecked one of 
the entrances. 

Malo-les-Bains and Dunkirk were frequently shelled by a 
15-in. long distance naval gun. On the 27th June the shelling 
commenced m the early morning, and shells fell every seven 
minutes in Malo-les-Bains. One of them by a direct hit at 



180 MEDICAL HISTORY OF THE WAR 

5-30 a.m. destroyed the Casino, which was occupied as offices 
of the XVth Corps Headquarters, killing twelve and wounding 
twelve of the clerks. The bombardment ceased at 11-30 a.m., 
after some forty-nine shells had been thrown. The wounded 
were taken to the Queen Alexandra Red Cross Hospital. The 
headquarters of the corps then moved to Bray Dunes Plage. 

Dunkirk was again shelled by the same naval gun on the 
last day of September, most of the shells falling in the docks. 
La Panne hospital was shelled on the 1st and 11th September. 

The corps main dressing station at Groote Kwinte Farm 
was heavily shelled in the afternoon of the 27th August, twenty- 
five shells falling in or near it in fifty minutes. The patients 
were rapidly evacuated, the only casualty being the Roman 
Catholic chaplain, who was killed. 

The D.M.S. of the Fourth Army then decided that as the 
casualty clearing stations at Oosthoek were close up to the 
front and on the Decauville railway running from the front, 
a new main dressing station was unnecessary. All serious 
cases were then sent direct to the casualty clearing stations, 
from the advanced dressing stations, and slight cases to the 
XVth Corps rest station. 

The casualty clearing stations at Oosthoek had to be closed 
in September on account of the constant shelling in their 
vicinity. Although they were not actually hit, shells had 
dropped quite close to them on the 4th September, and the 
nursing sisters, forty-five in number, were withdrawn to 
No. 10 Stationary Hospital at St. Omer. Shelling continued 
during the day, and several fell near No. 24 C.C.S., although 
not actually dropping on it. Four hundred and seventy-six 
patients were then evacuated by train to the base, and 220 to 
No. 34 and No. 36 C.C.Ss. at Zuydcoote. 

Enemy air raids were especially active in September, 270 
bombs having been dropped on the last day of the month in the 
back area. The number of wounded during the month was 
62 officers and 1,713 other ranks, chiefly from bombs and 
shell-fire. Air raids were also very frequent in October, as 
many as eleven out of fourteen occurring in the last fifteen 
days of the month. 

Mustard gas attacks were commenced against the XVth 
Corps front about the same time as mustard gas was used 
against the Fifth Army front. They were of a specially 
severe chaiacter. The first cases were reported on the 11th 
July, and between then and the 25th July over 2,350 gas 
casualties had occurred, including 11 officers and 49 other 



THE DUNKIRK-NIEUPORT AREA, 1917 181 

ranks of the R.A.M.C. The 49th Division, suffered so 
severely between the 22nd and 26th July, that it had to be 
withdrawn from the line. These attacks were continued in 
September and during the remainder of the period of 
British occupation. 

Medical preparations for combined Naval and Military 
operations. 

While the two divisions occupying the front line were thus 
subjected to constant gas attacks, and the reserve divisions, 
corps and army troops in back areas were being shelled and 
bombed almost daily, the 1st Division was isolated at Le 
Clipon, in a quiet area seven miles west of Dunkirk, under- 
going special training for a combined naval and military attack 
on the coast behind the enemy lines. 

The division went into training in the latter half of July, 
and no patients were allowed to be evacuated from the camp 
area for reasons of secrecy. A special hospital was then 
equipped to accommodate 250 patients in order to retain all 
sick of the division when in the training area. The hospital 
was manned by No. 1 Field Ambulance. 

With a view to preparing them for the contemplated landing 
on the coast, the field ambulances were trained physically and 
in carrying loads, negotiating obstacles, loading and off-loading 
motor ambulances with special loads, packing panniers with 
modified contents, swimming and life-saving, semaphore 
signalling, night operations, and loading and off-loading from 
pontoons as a unit and in conjunction with the brigades to 
which the field ambulances might be attached. 

The scheme involved the employment of a field ambulance 
with each brigade, each field ambulance consisting of 7 officers, 
164 other ranks, and 6 mechanical transport drivers, with 
additional dressings and comforts. Two motor ambulance 
cars, 2 motor cycles, 4 handcarts, and 1 bicycle were to be 
taken with each field ambulance, but no other kind of transport 
was to be made available. A field day was held on the 19th 
September with one of the brigades, and 300 casualties handled 
satisfactorily. 

The camp was given up towards the end of October. 

The transfer of British units from the Coast area. 

The British then abandoned the coast area. The D.M.S. of 
the Fourth Army closed his office at Malo-les-Bains on the 
5th November, moving to Dury, near Amiens, but when the 



182 MEDICAL HISTORY OF THE WAR 

D.M.S., Second Army, proceeded with the Second Army 
headquarters to Italy on the 16th November, Surg.-General 
O'Keeffe took over his duties in the Ypres area. After he left 
Dunkirk, the D.D.M.S., XVth Corps, remained in adminis- 
trative medical charge of the area, until it was finally 
handed over to the French. Colonel Newland handed over 
his duties as D.D. M.S. of the XVth Corps to Colonel Whaite 
and became D.D. M.S. of the XlVth Corps, which was moving 
to Italy, and on the 17th November the XVth Corps area 
was handed over to the 36th French Corps. 

The two casualty clearing stations, Nos. 34 and 36, at 
Zuydcoote remained open in October. When they were closed 
their equipment was brought to St. Omer in the ambulance 
flotilla barges. 

No. 1 Canadian Casualty Clearing Station went to the First 
Army, and opened at Ruitz. Two of the flotillas, Nos. 3 and 4, 
were demobilized on the 18th November. 

No. 24 and No. 39 C.C.Ss., were transferred to Italy, and 
No. 34 CCS. and other medical units to the Fifth Army 
south of the Somme, with the exception of No. 36 CCS., 
which after remaining parked for some time at St. Omer was 
transferred at the request of the Fourth Army Commander to 
Roosbrugge. 



CHAPTER XI. 

THE CAMBRAI OPERATIONS IN 1917. 

THE preparations for the battle of Cambrai, commenced on 
the 20th November 1917, were conducted with the utmost 
secrecy by the G.O.C. and staff of the Third Army. There 
was no preliminary bombardment, the attack on the enemy 
defences being heralded by large numbers of tanks smashing 
through his wire, followed by an advance of infantry under 
an artillery barrage. The cavalry were in readiness to take 
advantage of any gap which might enable them to go through. 
French cavalry had also been brought up to co-operate with 
the British cavalry. 

The sector selected for the attack was a front of some 3 to 
4 miles of the Hindenburg line, from Gonnelieu to the Canal 
du Nord, just north of Havrincourt Wood. The first objective 
was to secure the Bourlon Wood north of the line, in the angle 
formed by the Cambrai-Bapaume and Cambrai-Arras roads ; 
the enemy near Cambrai was then to be rounded up. 

The corps engaged in the battle were the Hlrd and IVth 
and the Cavalry Corps. 

At the time of the first attack the divisions of the Hlrd 
Corps were the 6th, 12th, 20th, and 29th. 

The IVth Corps divisions were the 36th, 56th, 62nd, and 
51st, and those of the Cavalry Corps the 1st, 2nd, 3rd, 4th 
(Indian), and 5th (Indian) Cavalry Divisions. 

Before the operations ceased the Hlrd Corps was reinforced 
by the 36th, 61st, Guards, and 9th Divisions, and the IVth 
Corps also by the 9th, Guards, 40th, 2nd, and 47th Divisions, 
some of these divisions being moved from one corps to the 
other as the situation demanded. 

The Vllth Corps was on the right of the Third Army 
opposite Vendhuille with its 55th Division on the right of the 
Illrd Corps. 

The Vth Corps had joined the Third Army from the Flanders 
Front just previous to the battle and was in reserve. 

The Vlth Corps was on the left of the IVth Corps, with the 
XVIIth Corps further north on the right of the First Army. 

10134 P 



184 MEDICAL HISTORY OF THE WAR 

The divisions engaged at the commencement of the battle 
were the 12th, 20th, 6th, 51st, 62nd, and 36th Divisions, with 
the 29th and 56th in support. The 3rd and 16th Divisions of 
the Vlth Corps made a subsidiary attack at Bullecourt further 
north. 

The initial attack resulted in an advance of four and a half 
miles, the Canal de St. Quentin and the Escaut being crossed 
at Marcoing. Masnieres on the opposite bank was occupied. 
A squadron of the Canadian Cavalry Brigade of the 5th (Indian) 
Cavalry Division went through and crossed the canal, but 
eventually withdrew at nightfall, after the greater part of its 
horses had become casualties. 

The advance was continued on the 21st November, dis- 
mounted regiments of the 1st and 5th (Indian) Cavalry 
Divisions taking part. The outskirts of Bourlon Wood were 
reached that day. 

Fighting was resumed on the 23rd November by the 56th, 
40th, and 36th Divisions and dismounted cavalry of the 1st 
Cavalry Division, and Bourlon Wood was captured. Bourlon 
village was occupied the following day, but was recaptured by 
the enemy on the 25th November. On the 27th November a 
final effort was made to secure the position held in Bourlon 
Wood and ridge by the Guards Division and the 62nd Division, 
assisted by tanks. 

The British offensive then ceased, but during the last days 
of November the enemy commenced his preparations for a 
counter-offensive, which he launched on the 30th November. 
The right of the British line south of Gonnelieu was attacked 
in flank and overwhelmed, the enemy advancing beyond the 
village of Villers Guislain, until held up by the 5th (Indian) 
and 4th (Indian) Cavalry Divisions, the Guards and the 61st 
Divisions, which came up from reserves. The divisions 
attacked were the 55th, 12th, 20th, and 29th Divisions, but 
the 55th on the right flank and the 29th on the left held their 
ground, the former falling back slightly, the latter not at all. 
Further north a massed German attack was launched between 
Bourlon Wood and the Canal du Nord against the 47th, 2nd, 
and 56th Divisions. The fighting was of the fiercest description, 
but these old army and Territorial divisions held out against 
overwhelming numbers of the enemy. An attack was also 
made in the centre of the British salient at Masnieres, where 
the 29th Division, as already noted, maintained its ground. 
Fighting continued on the 1st and 2nd December, chiefly in 
the neighbourhood of Masnieres. The enemy's attack then 




MalbyftSons.Lrth. 



THE CAMBRAI OPERATIONS IN 1917 185 

became exhausted and, from the 4th December, fighting died 
down. The British line, however, was withdrawn to more 
secure positions on the following days, the new line running 
from north of Gonnelieu to the west of Marcoing, north of 
Flesquieres and back to a point in the original British line 
south of the Bapaume-Cambrai road. South of this, a portion 
of the original British line was in the enemy's possession, the 
new British line running west of the villages of Gonnelieu and 
Villers Guislain. 



General Medical Preparations for the Battle. 

The casualty clearing stations of the Third Army at the 
time of the attack were Nos. 21 and 48 at Ytres, Nos. 5 and 55 
at Tincourt, Nos. 45 and 49 at Achiet-le-Grand, Nos. 3 and 29 
at Grevillers, Nos. 20 and 43 at Boisleux-au-Mont, and Nos. 19 
and 8 at Agnez-les-Duisans, with No. 56 in the back area at 
Edgehill, and the Lucknow at Peronne-la-Chapellette. Some 
of the Third Army casualty clearing stations had just been 
moved to Italy, namely, No. 9 from Aveluy, and No. 38 from 
Bray. 

The stationary hospitals at Frevent, St. Pol, Doullens, and 
Gailly, namely, Nos. 6, 12, 3 (Canadian), and 41, remained in 
the respective positions which they held during and after the 
battles of Arras. 

The chief problem which had to be faced was the reinforce- 
ment of these casualty clearing stations with surgical teams and 
extra equipment, without creating an impression that important 
operations were impending. 

The Army Commander was insistent on the maintenance of 
absolute secrecy, as any movement of reinforcements of casualty 
clearing stations that was observed by the enemy would indicate 
preparations for battle. Consequently only his D.M.S., 
Surg.-General Irwin, was kept informed of his intentions. 
Surg.-General Irwin had, however, informed his Army Com- 
mander that it would be impossible for him to obtain the 
necessary surgical help in his casualty clearing stations without 
the D.D.G.M.S. at G.H.Q. also being taken into his confidence. 
Permission was then given for him to see the D.D.G. at G.H.Q. , 
on the understanding that the latter alone should be informed 
of the intentions of the Third Army Commander. Although 
the operations were planned in association with the General 
Staff at G.H.Q. no information whatever reached the Director- 
General's office or D.D.G. on the subject from either the 



186 MEDICAL HISTORY OF THE WAR 

Adjutant-General or General Staff, but the D.D.G., Surg.- 
General W. G. Macpherson, had an interview with the General 
Staff, and let it be known that he was fully cognisant of the 
preparations that were being made. He was then given a free 
hand by the General Staff to act as he thought best to bring 
up the necessary reinforcements to the casualty clearing 
stations in a manner which would prevent any knowledge of 
the impending attack leaking out. Fortunately at this time 
there was considerable movement of medical units to Italy, and 
the D.D.G. took advantage of this fact, and of the fact that 
the operations in the Flanders area had ceased, to order the 
return of surgical teams of the Third Army to their units, and 
to obtain further teams by instructing Ds.M.S. of other armies 
and of the L. of C. to send medical officers and other ranks to 
No. 6 Stationary Hospital, Frevent, with a view to their being 
transferred to another area, thus creating the impression that 
they were joining the Italian Expeditionary Force. He also 
ordered the two reserve outfits, not yet distributed to casualty 
clearing stations, from Boulogne to Frevent for the same 
purpose. The D.M.S. of the Third Army was informed 
immediately this personnel arrived at Frevent, and transport 
was then sent by him to remove and distribute the surgical 
teams and other personnel to the casualty clearing stations to 
which they were allotted. In this way the casualty clearing 
stations were reinforced by surgical teams who had no know- 
ledge until they arrived at the casualty clearing stations on the 
eve of the battle that any active operations were contemplated 
in the Third Army. 

The number of teams sent to the Third Army in this way 
from other armies and from the L. of C, and the additional 
medical nursing services and other personnel is shown in the 
table on the next page. 

In addition to the teams, belonging to his own casualty 
clearing stations, which had been temporarily attached to 
casualty clearing stations of the Fifth and Second Armies for 
the Battles of Ypres, the D.M.S.'s original requirements were 
three teams for each of the casualty clearing stations at Ytres 
to arrive on the 17th, 2 teams for each of those at Grevillers 
to arrive on the 18th November, and 1 team each for the two 
casualty clearing stations at Tincourt, for No. 20 at Boisleux- 
au-Mont and for the two casualty clearing stations at 
Achiet-le-Grand to arrive on the 19th November. It will be 
seen from the table, however, that the distribution of teams 
was slightly different. 



THE CAMBRAI OPERATIONS IN 1917 



187 



Table showing additional Surgical Teams and Medical 
Personnel attached to Casualty Clearing Stations of 
the Third Army on 20th November 1917. 



Casualty Clearing 
Station Centre. 


Casualty 
Clearing 
Station. 


Number of 

additional 

surgical 

teams. 


Additional medical 
personnel. 


M.Os. 


Sisters. 


O.R. 


Grevillers 

Tincourt 

Ytres 

Agnez-les-Duisans 

Boisleux 

Achiet-le-Grand 

Edgehill 

Peronne la Chapellette 


No. 3 
No. 29 

No. 5 
No. 55 

No. 21 
No. 48 

No. 8 
No. 19 

No. 20 
No. 43 

No. 45 
No. 49 

No. 56 

Lucknow 


2 
3 

2 
2 

3 
3 

nil 
nil 

1 

nil 

1 

1 

nil 
nil 


7 
11 

5 
5 

17 
12 

nil 
nil 

4 
3 

4 
3 

2 

nil 


8 
14 

3 
9 

15 
10 

nil 
nil 

nil 
2 

nil 
3 

nil 

nil 


52 
52 

37 
29 

83 
67 

nil 
nil 

24 

24 

26 
36 

17 

nil 



The surgical teams were provided mainly by other armies, whilst the sisters 
came from the base and lines of communication hospitals, also from the 
stationary hospitals attached to the Third Army. 

Additional medical officers and other ranks were provided by the field 
ambulances of the corps from which the casualty clearing stations were to 
receive casualties. 



The generalpolicy was that, while teams arriving from casualty 
clearing stations in other armies should take with them a set 
of equipment,* teams from the hospitals on the L. of C. would 

* Each team from other casualty clearing stations was to bring with it 
the following operating requirements : — 

1 operating table. 
10 scalpels. 

10 artery forceps. 
4 dissecting forceps. 
6 pairs of scissors. 

2 large and 2 small retractors. 
8 towel clips. 

4 Lane's tissue forceps. 
2 intestinal clamps. 

An anaesthesia apparatus, and 

An instrument steriliser. 



188 MEDICAL HISTORY OF THE WAR 

be provided with the necessary equipment from the special 
reserve sets of outfits held at Boulogne and sent to Frevent. 

Each corps of the Third Army was ordered to send from 
field ambulances parties composed of 3 medical officers, 

3 N.C.Os. and 24 men to the various casualty clearing stations ; 

4 parties from the XVI I th Corps, 3 from the VI th Corps, 
2 from the IVth Corps, 2 from the Illrd Corps, and 2 from 
the Vllth Corps. 

The general arrangements then made for the clearing of the 
wounded and sick from the different corps are shown on the 
diagram. 

Wounded from the Tank Corps were to be evacuated 
according to the arrangements of the division in whose area 
the tanks were operating. From the Cavalry Corps they 
were to be evacuated to the nearest casualty clearing station. 
Indians were, however, to go to the Lucknow C.C.S., but 
serious cases were to be sent to the nearest casualty clearing 
station. 

Each corps had one motor ambulance convoy allotted to 
it. These were supplemented as required by fifty motor 
ambulance cars, which were sent to Frevent from the First 
Army, and placed at the disposal of the D.M.S., Third Army. 

Seventy buses or charabancs were allotted for evacuation 
of the sitting cases, 30 to the Illrd Corps and 30 to the IVth 
Corps, with 10 in reserve. 

Reserves of stretchers and blankets were kept in dumps at 
Ytres (750 stretchers), Tincourt (500 stretchers), Grevillers 
(1,000 stretchers and 3,000 blankets). They were to be used 
for exchange of stretchers and blankets brought back from 
the front. They were placed in charge respectively of Nos. 45, 
5, and 3 Casualty Clearing Stations. 

Up to the 18th November no urgent wires for extra stores 
were allowed to be sent to the Base Depots of Medical Stores, 
but on that date four lorry loads of stores arrived from No. 13 
Base Depot of Medical Stores, Abbeville, and 30,000 bandages 
and other equipment from the First Army. 

Entraining medical officers were allotted to each ambulance 
train loading station, namely, at Tincourt, Grevillers, Ytres, 
Doullens, Villers - Bretonneux, Achiet - le - Grand, Edgehill, 
Boisleux-au-Mont, and Peronne-la-Chapellette. At those 
stations where there were two casualty clearing stations, an 
assistant entraining officer was also allotted. These officers 
were obtained from the casualty clearing stations or stationary 
hospitals in the locality. 



Scheme of Evacuation op Sick and Wounded from 1V&TH Corps 
during The Battle ofCambrai , November 1917. 



IV CORPS 



Right S&ctor. 




'CCS 
G&EWLLERS. 



fS6 

:.cs. 

/&GEH/LL. 



Ill CORPS 



> T . H Div. 20™ Ptv. 12™ P>v. 







T&cW ^'• c - s | ▼ cc " s - 



■' Lying cases. «-■ — ■— Wauunq Wounded 

—••• SicJr. 

NOTE. The above shows & corps method, of evacuation in 
the m Corps and a divisional method in the Tj? Corps. 




Chape u-£t~te. 



is zec-ec.5060 ' i<u . fsoo n Z3. 



MEDJCAL SITUATION IN THE IV & III CORPS DURING THE BATTLE OF CAMBRAI NOVEMBER 1917. 




+ Reg A id Post. QAcfy.Dr. Sta. A W/kng. Wnd. Sta. E3 Main 0n Sta § Cas. CI Sta. -*-*•*- Decauvi'lle. Railway, - t-m 1 1 1 h Other Railways. 
— Original British Front Line, Nov. 19*$ m-m. British Line,Noven?ber2l s . t -•-• British Line, Nov. 29*." •••••Final Br. Line. Dec?*/ 1 

'-ww The Hindenburg Line. ///////////////, Qorps Area Boundaries . 
NOTE. The shaded conventional signs represent positions occupied by Advanced and Main Dressing Stations during the 
British advance. The Advanced Dressing Station at Villers Guislain was captured by the enemy during the German advance- 

'Z/0.24S4? 5060. I4J. 1500,8.23. 

Malby&Sons.Lith. 



THE CAMBRAI OPERATIONS IN 1917 189 

The usual policy of filling the casualty clearing stations in 
rotation by 150 stretcher cases at a time was followed, except 
where both lying and sitting cases were received, and then 
200 were taken in at a time. 

Medical Arrangements in Corps and Divisions. 

The same secrecy had to be maintained in the organization 
of the corps and divisional medical services. The preparation 
and expansion of advanced dressing stations, walking wounded 
collecting posts and so on were prohibited until the evening 
before the battle. Divisions which were to take part in the 
attack occupied their sectors only two days before it was 
launched. But divisions holding the line until then prepared 
accommodation and gradually accumulated as much additional 
stores as possible, while the medical officers from the attacking 
divisions were sent up to reconnoitre the area. 

The Illrd Corps. — The Illrd Corps headquarters with 
Colonel S. Macdonald as D.D.M.S., were at Templeux-la-Fosse. 
On the 9th November the divisions allotted to the corps were 
the 12th on the right, the 20th in the centre, and the 6th on 
the left, with the 29th in reserve ready to pass through the 
20th and push on and capture the Canal crossings at Marcoing 
and Masnieres. These divisions were resting in the back area 
and were only brought up during the three days preceding 
the offensive. The 20th Division alone was in the line before 
then. It had a divisional main dressing station on the Fins- 
Nurlu road, and advanced dressing stations at Gouzeaucourt 
and Villers Guislain, with a corps rest station at Moislains, 
and was evacuating its sick and wounded to Ytres and 
Tincourt. 

The main dressing station was hutted, well equipped with 
electric light, operating theatre, and gas treatment centre, 
and could be made to accommodate 500. 

The advanced dressing station at Gouzeaucourt was in 
cellars with ample accommodation and well protected. That 
at Villers Guislain was small. 

Immediately before the advance, the 20th Division retained 
Gouzeaucourt as its advanced dressing station, Villers Guislain 
was handed over to the 12th Division, and the 6th Division 
had to form a new advanced dressing station, north of 
Gouzeaucourt. 

A corps walking wounded station was also prepared alongside 
the corps main dressing station. 



190 MEDICAL HISTORY OF THE WAR 

Additional equipment and stores consisting of 2,000 stretchers, 
6,000 blankets, and 48 marquees were obtained. 

No. 21 Motor Ambulance Convoy came under the corps 
administration and was at Peronne ; but was moved to 
Moislains before the attack. 

The whole of the medical arrangements were complete by 
the 19th, all posts being amply stocked with additional equip- 
ment and dressings. 

It was decided that the lying down wounded were to be 
evacuated direct from the advanced dressing stations to the 
casualty clearing stations, as the position of the casualty 
clearing stations at Ytres favoured this. It was anticipated, 
however, that if walking cases were sent direct to casualty 
clearing stations, the latter might become rapidly congested 
with them, and it was consequently arranged to send the 
walking cases in the first instance to the corps walking wounded 
collecting station before transferring them to the casualty 
clearing stations. 

The corps main dressing station was kept as a reserve in 
case the casualty clearing stations became congested. 

Some of the A.Ds.M.S. of divisions were not entirely in 
favour of this method of direct evacuation from the advanced 
dressing stations, mainly on account of the difficulty in 
obtaining accurate returns for the divisional headquarters. 
The officers commanding the casualty clearing stations were 
also doubtful whether it would be possible to prepare returns 
and give anti-tetanic serum to cases evacuated to them direct. 
It was consequently decided that the field medical cards 
were to be made out at the advanced dressing stations and 
the anti-tetanic serum given on arrival of wounded at the 
casualty clearing stations. Events, however, proved that it 
would have been simpler for the anti-tetanic serum to have 
been administered at the advanced dressing stations and the 
field medical cards made out at the casualty clearing stations, 
instead of the reverse process. 

The necessity of maintaining secrecy made it impossible to 
enlarge the casualty clearing station centres previous to the 
battle, and the fact that the casualty clearing stations were in 
groups of two instead of three added to the difficulties of 
direct evacuation to them from the advanced dressing stations. 

The Illrd Corps had at its disposal four covered ambulance 
wagons on the Decauville railway fitted with necessary 
equipment and heated by oil stoves. The railway system 
connected two of the three advanced dressing stations with 



THE CAMBRAI OPERATIONS IN 1917 191 

the corps main dressing station, the corps walking wounded 
station, and all the casualty clearing stations. 

Decauville ambulance trains and motor ambulance cars 
were available for bringing back the stretcher cases. For the 
walking wounded there were the buses and returning empty 
Decauville trains. 

Two Decauville ambulance trains, each with two ambulance 
wagons and one ordinary wagon, were formed, the ordinary 
wagon being for the conveyance of walking cases from the 
advanced dressing stations to Fins. From Fins horsed 
ambulance wagons and motor buses were assembled for 
bringing the walking wounded to the walking wounded 
collecting station. From there they were transferred to the 
casualty clearing stations at Tincourt by an improvised 
Decauville train, consisting of six trucks covered with 
tarpaulins, and by buses or lorries. 

The time taken by the Decauville ambulance trains proved 
to be longer than was anticipated ; for the circular trip 
from the corps walking wounded collecting station to Tincourt 
took five and a half hours instead of four hours. 

Divisional motor ambulance cars were pooled to form an 
additional convoy. 

Sick were sent to the corps walking wounded collecting 
station and transferred from there to the corps rest station at 
Moislains by buses or ambulance cars, with the exception of 
serious cases which went to the casualty clearing stations. 
They were thence, if necessary, transferred to No. 56 CCS. 
at Edgehill. 

Buses and lorries worked well during the day of the 20th. 
The former were, however, withdrawn at 4 p.m. on that day, 
but a number of lorries was obtained in their place, together 
with twenty-five motor ambulance cars from the D.M.S. of 
the Army. 

The IV ih Corps. — In the IVth Corps the divisions on the 
northern sector were not likely to be heavily engaged and the 
arrangements made during the quiet periods of trench warfare 
were considered sufficient for all practical purposes as regards 
evacuation from that area. On the southern sector, however, 
it was anticipated that there would be great difficulties in 
connexion with evacuation as there was practically only one 
road from Flesquieres-Ribecourt to Metz-en-Couture and 
Ytres. This line of evacuation for the 51st and 62nd Divisions 
was likely to be seriously blocked by traffic immediately after 
the attack. 



192 MEDICAL HISTORY OF THE WAR 

A corps main dressing station was established by the 51st 
Division at Ruyaulcourt, and an advanced dressing station 
on the south of Havrincourt Wood, north of Metz-en-Couture. 
From this advanced dressing station stretcher cases were to 
be evacuated direct by the motor ambulance cars to the 
casualty clearing stations at Ytres. It was also intended to 
make use of the Decauville railway system, if possible, by the 
services of three trains running constantly from the advanced 
dressing stations to Ytres. A special siding had been prepared 
at the advanced dressing station for the purpose. The 
general intention was, as in the Illrd Corps, not to use the 
corps main dressing station unless necessary, but to bring 
patients direct from the advanced dressing stations to the 
casualty clearing stations. The main dressing station was, 
however, to be kept ready for wounded, whom it might be 
necessary to evacuate by road, from the left sector. 

A corps walking wounded collecting station was established 
by the 62nd Division at the south-west corner of Havrincourt 
Wood. Wounded were to be evacuated from that point to 
field ambulances at Bus by the Decauville railway. They 
were to be taken from Bus in buses to the casualty clearing 
stations at Grevillers. 

The 36th Division on the left of the 62nd Division had one 
brigade in the line on the Canal du Nord, with two brigades 
in reserve and with the 56th Division on its left. Advanced 
dressing stations were at Hermies for the 36th, and at Doignies 
for the 56th Division, with main dressing stations at 
Lebucquiere and Beugny. 

Dumps of 1,000 stretchers, 3,000 blankets, 20 small marquees, 
and 20 oil stoves were formed at Ruyaulcourt and Bus, and 
there were in the corps area on the 18th November, exclusive 
of the mobilization equipment of the medical units, as many 
as 16,548 blankets, 3,828 stretchers, and 56 small marquees. 
The erection of marquees for the walking wounded posts 
was only permitted under cover of darkness on the night of the 
19th/20th. 

Thirty buses were allotted to the D.D.M.S. IVth Corps and 
assembled at Bus on the morning of the 20th November. 
No. 27 M.A.C. was attached to the corps, and the general 
supervision of evacuation by means of the field ambulance cars 
and motor ambulance convoy cars from the advanced dressing 
stations was to be under the officer commanding the convoy. 

There were two light railway companies with the IVth 
Corps, No. 9 with its headquarters at Ytres, and No. 4 with 



THE CAMBRAI OPERATIONS IN 1917 193 

Its headquarters at Bapaume. On No. 9 light railway com- 
pany's system eight trucks were made available for wounded, 
each carrying twelve lying cases. A train composed of two 
or three of these trucks was normally kept at Ruyaulcourt. 
On No. 4 light railway company's system there were four 
covered ambulance trucks with capacity for twelve lying down 
in each, normally kept at Lebucquiere or Beugny. 

Walking cases were sent down on the returning empty trains. 

No. 9 railway system had sidings running into the casualty 
clearing stations at Ytres, and No. 4 had detraining posts a 
little to the south-west of Bapaume, where the wounded were 
unloaded and taken by car to Grevillers, three motor ambulance 
cars with two medical officers and a stretcher party being 
stationed there for the purpose. 

The Vlth Corps. — In the Vlth Corps, which was on the 
right of the IVth Corps during the battle, similar arrangements 
had been made with regard to the use of the light railway. 
Three different patterns of ambulance trucks had been con- 
structed, one was an open truck for trench tramways carrying 
three stretchers, another type was a light railway truck, with 
framework and cover, taking twelve stretcher cases, and the 
third type was a truck heated by a coke stove and fitted with 
spring supports for twelve stretchers. It was covered with 
waterproof canvas, and could be loaded by four loading parties 
in forty seconds. It was comfortable and warm. It was pro- 
posed to supply twelve of these converted trucks for use 
with the Vlth Corps. 

Light railway sidings were prepared at No. 45 and No. 49 
C.C.Ss. at Achiet-le-Grand, the lines running up to the main 
dressing station at Favreuil, north of Bapaume. 

The Cavalry Corps. — The arrangement in the Cavalry Corps 
for the attack on the 20th November was for the wounded to 
be evacuated through the regimental aid posts and advanced 
dressing stations of the Illrd and IVth Corps. Clerks were 
to be sent to the walking wounded collecting stations and to 
the casualty clearing stations at Grevillers and Tincourt for 
recording the admissions. 

The Cavalry Corps headquarters were then at Villers 
Carbonnel. Its advanced headquarters went to Fins at 6 a.m., 
on the 20th November. 

The cavalry brigades were accompanied by the pack mounted 
sections of cavalry field ambulances,* v/hich were parked at 

* See Chapter IV. 



194 MEDICAL HISTORY OF THE WAR 

Fins. The light sections were to go forward as far as possible 
with dismounted stretcher bearers in the ambulance wagons. 
They were to be followed by the heavy sections and the motor 
ambulance cars. The heavy sections were to take over the 
advanced dressing stations in the event of a successful advance, 
and the cars were then to clear the wounded from them to the 
most advanced infantry medical units. The duty of the pack 
mounted sections was to supplement regimental aid posts and 
collect wounded to places along the roads or into barns or 
houses. 

The D.M.S. of the Third Army was anxious to obtain inform- 
ation regarding the suitability of tanks for bringing wounded 
back from forward positions in cavalry action. A large store 
tank supplemented by a trailer was reported to be suitable 
for both stretcher and sitting cases ; but there is no record of 
its having been used. 

The Medical Services during the Battle. 

The Illrd and IV ih Corps Medical Services. — During the 
first phase of the battle, November 20th to 28th, the total 
casualties received into the medical units were 17,293, of 
whom 689 were officers, 15,038 other ranks, and 1,566 enemy 
wounded. The system of evacuating the seriously wounded 
direct to the casualty clearing stations at Ytres from the 
advanced dressing stations of both the Illrd and IVth Corps 
was not altogether a success. By the evening of the 20th 
November Ytres was full of wounded and unable to take more. 
Illrd Corps wounded were consequently switched off to 
Tincourt, and the IVth Corps wounded to Grevillers. Owing to 
the large numbers coming by ambulance car and by Decauville 
trains some of the cars and trains were kept waiting for one or 
two hours before they could be unloaded after arrival at Ytres 
and consequently there was considerable delay in getting the 
trains back to the advanced dressing stations. Parties of 
stretcher bearers had consequently to be sent to Ytres to 
expedite the unloading of the trains and cars. 

When Ytres had thus to cease taking in casualties temporarily, 
and ambulance cars with the wounded were sent on instead 
to Tincourt, it became necessary to abandon the system of 
direct evacuation to casualty clearing stations from advanced 
dressing stations, on account of the long time the cars were 
away on the journey. The normal system of evacuation was 
then restored, namely, that of clearing the advanced dressing 
stations by the field ambulance transport to a main dressing 



THE CAMBRAI OPERATIONS IN 1917 195 

station and clearing the latter by the motor ambulance convoy- 
to the clearing stations. 

This experience of a system of direct evacuation from 
advanced dressing stations to casualty clearing stations is 
important, as it emphasizes the fact that wounded as a whole 
are not more advantageously dealt with in battle under such 
a system than they are under the normal system. The rule, 
however, that the comparatively small number requiring 
urgent operations, such as men wounded in the abdomen, 
should be sent direct to the nearest casualty clearing station 
or advanced operating centre always held good ; but there 
was no advantage in dealing with all the lying down wounded 
in the same way. The general result was that wounded were 
held up for long periods either at advanced dressing stations 
pending the return of cars, or at casualty clearing stations 
until the cars could be unloaded or until the congestion at the 
casualty clearing stations could be relieved. 

The difficulties which arose at Ytres in this respect did not 
occur to the same extent at Tincourt. The number of wounded 
from the southern sector was less. The Decauville train, however, 
from the advanced dressing station at Villers Guislain did not 
run well, owing to the tractor being unable to pull the wagons 
up the hill between the station and Tincourt. 

The night of the 20th/21st November was very dark and 
wet, and some of the ambulance cars, which had to move 
without lights, got ditched. The roads had been damaged 
by shell fire and had become impassable in many places for 
wheeled vehicles. This was more especially the case in the 
IVth Corps area. 

After the advance had been made to Marcoing, the Decauville 
railway was linked up with the German Decauville system and 
on the 21st ran up to Trescault, and subsequently to Ribecourt ; 
but it was not possible to use it for the evacuation of seriously 
wounded from the IVth Corps. 

During the advance on the 20th and 21st November the 
wounded of the IVth Corps had to be carried by hand from 
the aid posts and advanced dressing stations, as the roads 
leading to them had been destroyed by shell fire in many 
places. The 62nd Division had opened an advanced dressing 
station at Havrincourt in ruined buildings. The road between 
that place and Trescault was in a very bad condition, and 
the wounded had consequently to be taken back north of 
Havrincourt Wood across the Canal du Nord by hand carriage 
towards Hermies to the 36th Division advanced dressing station. 



196 MEDICAL HISTORY OF THE WAR 

On the 23rd November the wounded both of the 36th and 
the 62nd Division had to be carried there by several relays, 
for a distance of about four miles in some cases, owing to the 
condition of the roads. An advanced dressing station was 
then established at Graincourt between Bourlon Wood and 
Flesquieres. The 51st Division had formed an advanced 
dressing station at Flesquieres immediately after it had been 
captured on the 21st November, and the advanced dressing 
station at Graincourt was cleared to it. 

On the 25th November ambulance cars were able to run 
between Trescault and Ribecourt, although with considerable 
difficulty owing to the condition of the road, but later in the 
day a large number of cars were able to work between 
Flesquieies and Ytres, via Ribecourt, Trescault, and Metz, 
which was the main line of evacuation from the right sector 
of the IVth Corps. 

Wounded of the 36th Division on the left were evacuated 
through Demicourt and Hermies to Lebucquiere, and thence 
by cars and Decauville railway to Grevillers. The walking 
wounded found their way to Ribecourt on foot and were taken 
back on the Decauville railway trucks from there. 

The work of clearing aid posts and dressing stations by 
road was hampered not only by the damage done by shell 
fire, but also by the roads being congested with traffic of all 
kinds. Thus on the 20th November, when the 62nd Division 
advanced on Havrincourt, the roads became packed with 
guns and transport and it was impossible to use ambulance 
transport on them till late in the afternoon. The only roads 
suitable for transport were through Trescault to Havrincourt 
and through Havrincourt High Woods to the north-east 
corner of the wood. No motor transport could advance 
beyond these points, and as already noted an alternative 
route of evacuation was established north of Havrincourt to 
the 36th Division advanced dressing station at Hermies. 
By the 25th November, however, horsed ambulance wagons 
could be employed between Graincourt advanced dressing 
station and Flesquieres, and thence through Ribecourt or 
Havrincourt. 

The Illrd Corps divisions were more favourably placed 
than those of the IVth Corps after the advance. On the 21st 
November the 29th Division had gone through the 20th 
Division and had opened advanced dressing stations at Marcoing 
and Masnieres with a walking wounded collecting post at 
La Vacquerie, half-way between Gouzeaucourt and Masnieres. 



THE CAMBRAI OPERATIONS IN 1917 197 

The 6th Division had moved its advanced dressing station 
to Ribecourt with a collecting post at Villers Plouich. The 
other divisions in the line, the 12th and 20th, had their advanced 
dressing stations at Gonnelieu and Gouzeaucourt. 

The Cavalry Medical Services. — The A.D.M.S. of the 5th 
(Indian) Cavalry Division, a squadron of which had gone 
through the gap in the enemy's line on the 20th November, 
had assembled the pack mounted sections with their brigades, 
while the light sections and all motor ambulance cars were 
assembled at Villers Plouich ready to move to Rumilly and 
establish an advanced dressing station there. The heavy 
sections moved up to Fins from Bouchy near Tincourt during 
the day. 

The 1st Cavalry Division bearers and ambulance wagons 
were brought up to Ribecourt ready to advance to Marcoing. 
A cavalry field ambulance, the Lucknow, of the 4th (Indian) 
Cavalry Division moved to Gouzeaucourt on the 22nd 
November, with its pack mounted section at La Vacquerie. 
The stretcher parties went forward to a relay post near Mar- 
coing on the 21st November, and according to the diary of 
the A.D.M.S., there was no difficulty in collecting the wounded 
of the 5th Cavalry Division during the mounted operations 
on that day. 

The majority of the casualties were in the Canadian Cavalry 
Brigade. 

The Medical Services during the German Counter- Attack. 

In the second phase of the battle, when the German attack 
took place on the 30th November, the disadvantage of having 
large immobile dumps of medical stores in advanced centres 
and casualty clearing stations near the front line became 
prominent. The medical units chiefly affected were those of 
the Vlth Corps and the casualty clearing stations at Ytres. 
The advanced dressing stations at Villers Guislain and 
Gouzeaucourt fell into the hands of the enemy by 10 a.m., and 
some of the personnel of No. 36 Field Ambulance at Villers 
Guislain were captured. The personnel of the A.D.S. at 
Gouzeaucourt got away together with the wounded before the 
enenty entered the village, but a dump of stretchers, blankets, 
marquees, and other stores was left behind. Gouzeaucourt 
was, however, recaptured some hours later. 

The Guards Division, which was brought down from the IVth 
Corps to this front, formed advanced dressing stations between 
Gouzeaucourt and Gouzeaucourt Wood, and on the road 



198 MEDICAL HISTORY OF THE WAR 

between Gouzeaucourt and Fins, where the 20th Division 
also had its advanced dressing station. The 12th Division 
opened a new advanced dressing station at Heudicourt. Seven 
cars of No. 21 M.A.C. were ditched and had to be abandoned, 
but the drivers canied the wounded away with them and 
also brought back the carburetters. Three of the field am- 
bulance cars were also put out of action. The main dressing 
station on the Fins-Nurlu road was cleared and the divisional 
rest station at Moislains was then prepared as a main dressing 
station, after the sick had been removed from it. 

The German attack, on the 30th November, resulted in 
many losses in medical personnel of the Illrd Corps. One 
officer was killed, three wounded, and six missing. Amongst 
other ranks, 1 was killed, 21 were wounded, and 163 missing. 

The left division of the Vllth Corps, the 55th, had its ad- 
vanced dressing station at Epehy when the enemy attacked. 
One officer and fourteen other ranks of the R.A.M.C. were 
captured while working between it and the aid posts. 

As might be expected, the casualty clearing stations at 
Ytres were in imminent danger of capture. Orders were 
consequently issued for the nursing sisters to be sent back by 
ambulance cars, and the surgical teams distributed amongst 
the casualty clearing stations at Tincourt and Grevillers. The 
remainder of the personnel were to salve as much of the equip- 
ment as possible and retire to places of safety, leaving sufficient 
personnel in charge of the wounded until all could be got 
away. It was considered unnecessary, however, to move the 
casualty clearing stations, although they were frequently 
shelled, and their position undoubtedly hazardous. 

In the northern sector, between the canal and Bourlon 
Wood, where the fighting was fiercest, 600 wounded had been 
collected to Flesquieres and 350 to Havrincourt by 9-30 a.m. 
on the 30th November, in addition to a large number of walking 
wounded at Trescault. Every available car was sent up, but 
the roads were blocked by traffic, and recent shelling had 
rendered the road from Flesquieies to Havrincourt impassable 
for ambulance cars. The railway lines from Ribecourt and 
Trescault and from Havrincourt to Grevillers were of great 
assistance. Many wounded were carried by hand from 
the Bourlon Wood to a relay post north of Anneux and thence 
by trolley line to a loading post between Anneux and Flesquieres, 
where ambulance cars took them to the main dressing station. 
From the west of Bourlon Wood the stretcher cases were 
carried to a sugar factory on the Cambrai-Bapaume road, and 



THE CAMBRAI OPERATIONS IN 1917 199 

on to a car loading point on the road between Graincourt and 
the canal, whence they were taken by car along the canal 
road to Havrincourt advanced dressing station. Walking 
wounded went back by the same road and on to Trescault. 

Bourlon Wood was severely bombarded by gas shells on the 
30th November, seven of the medical officers becoming casual- 
ties. Owing to the thick wood and undergrowth it was difficult 
to disperse the gas, even when a strong wind was blowing. 
The dressing station at Flesquieres was heavily shelled in the 
evening, three ambulance car drivers being killed, a wagon 
orderly wounded, and several horses of the field ambulance 
killed or wounded. The motor ambulance car service failed 
on account of congestion of the roads with other traffic, but 
two trains were run up on the broad-gauge railway from 
Grevillers to Havrincourt and relieved the congestion at the 
advanced dressing stations. 

The relay post at the sugar factory on the Cambrai road 
had good shelter and accommodation in cellars, but there 
were no trenches from it backward. The position was isolated 
and all approaches to it constantly shelled, and it was doubtful 
whether the good accommodation and comparative safety 
in the cellars were not more than counter-balanced by the 
risk to bearers and the necessity of keeping the wounded for a 
considerable time before they could be got away. 

The cavalry divisions during the enemy attack were 
dismounted and occupied sectors of the Vllth and Illrd 
Corps front. 

The Casualties. 

The number of wounded admitted to medical units daily 
during the battle and evacuated to the base is shown in the 
table on the next page. 

The greatest number of trains required for evacuation on 
any one day was eleven, on December 1st. On November 20th, 
eight were used, and on November 21st, 22nd, and 30th, seven. 
On December 2nd there were nine trains. 

Including sick, the total number evacuated up to December 
4th was 35,597, of whom 16, 939 were lying, 17,163 sitting, and 
1,495 German sick and wounded. 



10134 



200 



MEDICAL HISTORY OF THE WAR 



Number of Wounded admitted to Field Ambulances and evacuated 

to the Base. 





Woundec 


L 




Woundec 


I 






admitted 






evacuated 


. 




Date. 








Total. 








Total. 




Other 


Ger- 




Other 


Ger- 




Officers. 


ranks. 


mans. 




Officers. 


ranks. 


mans. 




Nov. 20 


153 


2,838 


222 


3,213 


62 


1,179 


75 


1,316 


21 


119 


2,623 


690 


3,432 


139 


3,253 


605 


3,997 


22 


63 


1,467 


416 


1,946 


80 


1,604 


330 


2,014 


23 


43 


1,039 


41 


1,123 


20 


748 


99 


867 


24 


107 


2,275 


62 


2,444 


87 


1,906 


82 


2,075 


25 


53 


1,290 


18 


1,361 


55 


897 


41 


993 


26 


53 


1,139 


24 


1,216 


53 


1,309 


51 


1,413 


27 


41 


1,089 


75 


1,205 


11 


305 


10 


326 


28 


59 


1,288 


— 


1,347 


86 


1,647 


34 


1,767 


29 


37 


715 


— 


752 


20 


299 


62 


381 


30 


87 


1,916 


— 


2,003 


74 


1,590 


7 


1,671 


Dec. 1 


246 


4,438 


49 


4,733 


201 


3,603 


13 


3,817 


2 


156 


3,731 


40 


3,927 


123 


3,478 


521 


4,122 


3 


58 


1,074 


6 


1,138 


47 


1,523 


47 


1,617 


4 


65 


1,444 


11 


1,520 


55 


938 


23 


1,016 


5 


29 


704 


1 


734 


30 


767 


12 


809 


6 


54 


741 


1 


796 


49 


808 


10 


867 


Totals . . 


1,423 


29,811 


1,656 


32,890 


1,192 


25,854 


2,022 


29,068 



CHAPTER XII. 

THE GERMAN OFFENSIVE IN 1918. 

THE numerical superiority of the German forces on the 
Western front, caused by the events in Russia, by the 
transfer of British divisions to Italy, and by the reduction 
of British divisions from 13 to 10 battalions, made a defensive 
policy along the whole line held by the Allies in France and 
Belgium imperative at the close of 1917. 

When the XlVth and Xlth Corps, with the 23rd, 41st, 7th, 
48th and 5th Divisions, were transferred to Italy between the 
9th November and 1st December of that year, several 
medical units were sent from France to Italy at the same 
time. The divisions were accompanied by their field 
ambulances and sanitary sections. Three sanitary sections 
preceded them for work at the base and on the lines of com- 
munication. Two motor ambulance convoys, No. 36 and 
No. 26 ; five casualty clearing stations, No. 9 from Aveluy, 
No. 38 from Bray, Nos. 24 and 39 from the Dunkirk area, 
and No. 37 from Godewaersvelde ; Nos. 15 and 23 Mobile 
Hygiene and Nos. 7 and 14 Mobile Bacteriological Laboratories ; 
No. 11 General Hospital from Etaples* and No. 38 Stationary 
Hospital, No. 32 Advanced Depot of Medical Stores, and 
a Convalescent Depot were transferred from France to 
Italy at this time. When two of the divisions, the 5th and 
41st, returned to France early in March 1918, with their field 
ambulances and sanitary sections, two of the casualty clearing 
stations, No. 38 and No. 37, also came back, the former on 
the 19th March and the latter on the 28th April. 

The transfer of British troops to Italy also involved special 
provision for the evacuation of their sick and wounded to 
France. For this purpose No. 57 General Hospital, then at 
Boulogne, was sent to Marseilles, and a large convalescent 
depot, No. 16, was formed there. A second general hospital, 
No. 81, came to Marseilles from Malta in January 1918. 
Several ambulance trains, the number of which varied from 

* This unit was occupied by the personnel of the Harvard Unit, U.S.A., 
but this personnel was transferred to No. 13 General Hospital, Boulogne, 
and the personnel of the latter went to Italy as No. 11 General Hospital. 



202 MEDICAL HISTORY OF THE WAR 

time to time, were employed in evacuating sick and wounded 
from Italy to the Marseilles base ; while Nos. 15, 18, 21 and 
26 Ambulance Trains were transferred permanently to Italy 
for use between the British front and base. 

The fitting out of the British force to Italy thus diverted 
some of the medical units and personnel of the R.A.M.C. from 
work on the Western front at a time when personnel was 
becoming more and more difficult to obtain. 

Colonel F. R. Newland had been appointed D.D.M.S. of 
the XlVth Corps in Italy, with Colonel S. L. Cummins as his 
A.D.M.S. for the Italian lines of communication, on the 28th 
October, but on the 23rd November the Second Army Head- 
quarters moved to Italy and then Surg.-General R. Porter's 
place, as already noted, was taken in France by the D.M.S. 
of the Fourth Army, Surg.-General O'Keeffe. As Colonel 
Newland, however, had been appointed D.M.S. of the British 
Expeditionary Force in Italy with the rank of Surg.-General 
by the War Office, Surg.-General Porter returned to France 
on the 4th December, and pending early retirement on account 
of age did not resume an administrative medical appointment 
in the field. 

In January 1918, the British front in France and Belgium 
was extended southwards in a continuous line of one hundred 
and twenty-five miles from Houthulst Forest in the north to 
Barisis, some six miles south of La Fere, on the Oise. This 
line was held from right to left by the Fifth Army from Barisis 
to north of Gouzeaucourt ; by the Third Army from that 
point to Gavrelle, north of the Scarpe ; by the First Army on 
its left to Armentieres ; and by the Fourth Army* between 
Armentieres and Houthulst Forest. Belgian troops were on 
the British left. French troops had taken the place of the 
latter on the coast sector. 

Medical Arrangements previous to the German attack. 

On the adoption of a defensive policy, the organization for 
defence consisted of a lightly held " forward zone," about 
one mile in depth, with a strongly wired " battle zone " some 
four miles in depth to which the troops in the forward zone 
were to retire in the event of attack. Behind the battle zone 
was a third defensive line. As the point at which the enemy's 

* The Fourth Army ceased to exist as such on the return of the Second 
Army Headquarters staff from Italy, its Commander, General Sir H. Rawlinson 
being appointed to the Supreme War Council in Paris. 

It was re-designated the Second Army from the 13th March. 191 8. 



GERMAN OFFENSIVE IN 1918 203 

anticipated attack might be launched was unknown, although 
the probability was that it would be against the Third and 
Fifth Armies in the direction of the coast ports, the D.G.M.S. 
was placed in the difficult position of determining how he 
might best reinforce the medical services of one army by 
transfer of units from another army in the event of sudden 
attack. His chief anxiety was caused by the forward position 
of many of the casualty clearing stations and the policy was 
enunciated that, in defensive operations, two casualty clearing 
stations should be open in a back area for one in a forward 
area, as distinct from the policy in offensive operations of 
having one casualty clearing station in a back area for two in 
a forward area. 

The Directors of Medical Services of the Fifth, Third, First 
and Fourth Armies respectively, were Major-Generals B. M. 
Skinner, Sir J. M. Irwin, H. N. Thompson and M. O'Keeffe. 
The Director-General had obtained details of the arrangements 
made by them and their Corps D.Ds.M.S. and Divisional 
A.Ds.M.S., for the collection and evacuation of wounded in the 
event of the British line being pushed back. From most of 
the armies and formations maps showing positions to which 
casualty clearing stations and other units in army areas would 
move in the event of a retirement were submitted to the 
D.G.M.S. early in March. The D.M.S., L. of C. also submitted 
a statement of the action to be taken by him.* 

Consequently, with a view to meeting the situation and 
ensuring that adequate reinforcements for medical services 
would be available for sending to any sector where a 
determined offensive by the enemy might take place, the 
following instructions were issued to the Ds.M S. of the Armies 
and L. of C. by the D.G M.S. on the 6th March 1918:— 

" 1. Casualty Clearing Stations. 

(a) The Fourth Army, which has a surplus of casualty clearing 
stations in proportion to divisions, will hold six of these casualty 
clearing stations ready to move at a moment's notice with the 
mobile equipment referred to in this office No. D.G. D/2279/71 
dated 30th September 1916. (Copy attached. )t 

* Surg. -General T. P. Woodhouse had reached the age limit for retirement 
in December 1917, and his place as D.M.S., L. of C. was taken by Surg. -General 
Can. 

t The copy attached was as follows : — 

" Recent moves of casualty clearing stations have shown that these units, so far as the 
transport required to move them is concerned, have become extremely unwieldy. For example, 
one casualty clearing station took 100 lorry loads and others 50 to 60 in order to move from 
one place to another. 

" You will please arrange, therefore, for each casualty clearing station to have ready now 
a list of the articles which are necessary for carrying on emergent surgical work and providing 
nursing facilities at main dressing stations or other suitable places in advance of its present 
position, whenever the necessity of moving a casualty clearing station forward arises. 

" This equipment should represent minimum requirements and should be limited to nine 
lorry loads, to enable a casualty clearing station to open for work immediately without waiting 
till the bulk of its material arrives." 



204 MEDICAL HISTORY OF THE WAR 

" These casualty clearing stations will be used : — 

(i) For reinforcing the casualty clearing stations in army areas 

whenever this becomes necessary, 
(ii) For opening casualty clearing stations rapidly on sites further 

back in the event of casualty cleaiing stations in forward areas 

being temporarily out of action, 
(iii) To open in any new area which may be taken over, 
(iv) To form casualty clearing stations with any Force that may be 

sent to opeiate elsewhere. 

" It is not intended that casualty clearing stations selected for this 
purpose should close down now, but they should be in a position to pack 
up and load on lorries the equipment referred to in the above quoted 
instruction with the least possible delay. 

" All Ds.M.S. will notify to this office as early as possible the sites 
selected, should move under (ii) be required. 

(b) Casualty clearing stations of one Army will be made available 
for wounded of the neighbouring Army, if required, under 
arrangements to be made by Ds.M.S. concerned in direct com- 
munication with one another. 

"2. Motor Ambulance Convoys. 

" Armies not actively engaged will be prepared to transfer one or 
more ambulance convoys to another area when required to do so by 
D.G.M.S. 

" In the event of any breakdown in the running of ambulance trains, 
reserve convoys are available for conveying wounded from the First and 
Fourth Armies to hospitals in St. Omer, and from the Third and Fifth 
Armies to hospitals in Amiens, Etaples and Abbeville. 

" Ds.M.S. will report to D.G.M.S. whenever it becomes necessary to 
carry out evacuation by road, notifying the casualty clearing station 
which requires immediate relief, and the numbers in it waiting evacuation. 

"3. Surgical Teams. 

(a) From casualty clearing stations. — Each casualty clearing station 
will be prepared to send, under Army arrangements, one 
surgical team as rapidly as possible to reinforce casualty clearing 
stations in the sectors attacked, whenever called upon to do so 
by D.G.M.S. 

" Each team will take with it the equipment noted in attached 
Appendix, marked ' A,'* and biing it back on returning to its own unit. 

(b) From Lines of Communication. — Teams have been earmarked to 
be sent up to casualty clearing stations as required from the 
L. of C. They will be sent to one or other of the stationary 
hospitals in army areas or adjoining L. of C. area, and handed 
over there to the Army concerned. The D.M.S. of the Army 
will then be responsible for distributing them to casualty clearing 
stations. 

* Appendix " A *' — Equipment to be taken with a surgical team from a casualty clearing 
station : — 

1 Operating Table. 8 Towel Clips. 

10 Sharp Scalpels. 4 Lane's Tissue Forceps. 

18 Artery Forceps. 2 Intestinal Clamps. 

4 Dissecting Forceps. Anaesthesia Apparatus. 

6 Pairs Assorted Scissors. Instrument Sterilizer. 

2 large, 2 small Retractors. 



GERMAN OFFENSIVE IN 1918 205 

" The following are the stationary hospitals most convenient for this 
purpose : — 

No. 42 for Fifth Army. 
No. 6 for Third Army. 
No. 12 for First Army. 
No. 10 for Fourth Army.* 
" But Ds.M.S. of Armies concerned will arrange direct with D.M.S., 
L. of C, any modifications of the above arrangements which they may 
find more convenient, and notify to this office. 

" It should be understood that the object of this arrangement is to 
enable Ds.M.S. to take over at recognized centres, and distribute by 
Army motor ambulance convoy teams coming from bases, such as Rouen 
and Treport, with women drivers or others who do not know the positions 
of casualty clearing stations. 

" Ds.M.S. will be prepared to accommodate teams and drivers at the 
stationary hospital should they arrive at an hour which prevents them 
moving on at once to the casualty clearing stations. 

"4. Special Surgical Sets. 

" The special surgical sets referred to in this office No. D.G. L. 2279/95 
dated 12th July 1917, will be sent to selected casualty clearing stations 
when surgical teams are sent up from the L. of C. Arrangements are 
being made to have the sets sent up if possible in advance of the teams, 
but Ds.M.S. will understand that, as the sector of operations is not known 
beforehand, it is possible that the teams may arrive simultaneously with, 
or before, the surgical sets. Every endeavour will be made, however, 
to get the sets up as early as possible. 

"5. Other Personnel. 

(a) The instruction that three medical officers and twenty-five men 
are to be added to each casualty clearing station in an Army 
area from field ambulances in that Army will hold good, but it is 
hoped that shortly this addition to each casualty clearing station 
will be made more or less permanent. 

(b) Other Armies not actively engaged will be prepared to send as 
many medical officers and other ranks as can be spared from 
field ambulances to casualty clearing stations of other Armies, 
when called upon to do so by D.G. M.S. 

"6. Stretchers. 

(a) In addition to the stretchers held on the mobilization scale of 
field ambulances and on the expanded scale for casualty clearing 
stations, there should be a reserve of stretchers which need not 
exceed 2,000 in each corps, including the stretchers held by 
field ambulances in rest stations, and 2,000 in Army Reserve, 
including reserve of stretchers held in casualty clearing stations 
or motor ambulance convoys. 

(b) Should these require to be replenished at any time, Ds.M.S. of 
Armies can obtain additional stretchers : — 

(i) From ambulance trains, and 

(ii) From a general reserve of stretchers held under D.G. M.S. 
control at G.H.Q. 
" This latter reserve will not be drawn upon except during an actual 
offensive, and is intended as a reserve to replace any loss of stretchers 
which may arise in connection with the operations or to provide stretchers 
rapidly in the event of its being necessary to expand medical units in 
new areas. 

* These stationary hospitals were respectively at Amiens, Frevent, St. Pol and St. Omer. 



206 



MEDICAL HISTORY OF THE WAR 



" 7. Blankets. 

" Reserves of blankets will be held with the reserves of stretchers, 
in the proportion of two blankets per stretcher in the Corps Reserve, 
Army Reserve and G.H.Q. Reserve. 

"8. Primary Suture of Wounds. 

" The procedure in connexion with primary suture of wounds is noted 
in Appendix marked ' B,'* and Ds.M.S. will take steps to see that all 
medical officers concerned thoroughly understand what is required in 
this respect." 

The Defensive position of Casualty Clearing Stations. 

The Fifth Army. — The Fifth Army, on taking over from the 
French the line from Gouzeaucourt to the Oise, had its casualty 
clearing stations established at the following places : — 



Noyon 


. No. 46.. 


14 miles from th 
front lme. 


Cugny 


No. 41.. 


9 


Ham 


No. 61.. . .. 


13 


Tincourt 


Nos. 5 and 55 . . 


6i „ 


Roye 


Nos. 50 and 53 


25 


Marchelepot . . 


Nos. 32 and 34 


17 


Rozieres 


No. 47 


25 


Peronne la Chapellett 


e Lucknow CCS. 


13 


Maricourt Plateau . 


No. 38 CCS. . . 


16 



(This casualty clearing station only arrived from Italy on the 
eve of the German offensive.) 

A stationary hospital, No. 41, was at Gailly on the Somme, 
some 14 miles west of Peronne la Chapellette. 

No. 42 Stationary Hospital, at Amiens, had come under the 
administration of the D.M.S., L. of C 

The Third Army. — By the beginning of March, the D.M.S. 
of the Third Army was withdrawing his casualty clearing 
stations from the two most forward positions at Ytres and 
Boisl eux-au-Mont . 

* Appendix " B." — Procedure in connection with Primary Suture of Wounds. 

"1. It is understood that all concerned in the treatment of wounds at casualty clearing 
stations and hospitals are now fully instructed in the principle of primary suture of wounds 
of the soft parts. 

"2. Primary suture will, however, only be resorted to when the patient can be retained in 
the unit for seven days. 

" 3. In the case of casualty clearing stations this is only possible in quiet times and when 
large numbers of wounded are not anticipated. 

" 4. When it is not possible to retain patients in casualty clearing stations for seven days 
the wounds of the soft parts will be cleaned up and destroyed tissue excised. The patient will 
then be evacuated with the wounds open with as little delay as possible. 

" 5. Patients whose wounds have been dealt with in this manner, that is to say, whose wounds 
have been prepared in casualty clearing stations for delayed primary suture in the L. of C. 
hospitals will have " D.P.S." (i.e., Delayed Primary Suture), clearly marked in block letters 
in the space under (3) of the Diary of Transference on the Field Medical Card envelope (Army 
Form W. 31 18. a.). 

" 6. Wounded arriving at Base Hospitals so marked will be attended to with the least possible 
delay, and, if there are no indications to the contrary, delayed primary suture carried out." 



SKETCH MAP SHOWING THE RELATIVE POSITIO N S OF CASUALTY CLEARING 

STATIONS AND HOSPITALS TO THE FRONT LINE D URIN G THE PERIOD OF DEFENCE 

PREVIOUS TO THE GERMAN OFFENSIVE IN 1918. 




GERMAN OFFENSIVE IN 1918 207 

A site for Nos. 21 and 48 from Ytres had been selected near 
Beaulencourt three miles south of Bapaume and some ten 
miles from the front line. Nos. 43 and 20 from Boisleux-au- 
Mont were being withdrawn to Le Bac du Sud on the Arras- 
Doullens road between thirteen and fourteen miles from the 
front ; one of the two casualty clearing stations, however, 
was being kept open at Ytres and Boisleux-au-Mont until the 
other was ready to receive patients on the new site. 

The casualty clearing stations at Agnez-les-Duisans, Achiet- 
le-Grand, Grevillers and Edgehill were left in position, but 
the two at Achiet-le-Grand, Nos. 45 and 49, were to withdraw 
to Grevillers in case of necessity, as, owing to their proximity 
to an important railway junction, they were likely to come 
under heavy shell fire. An alternative ambulance train 
siding for patients from the casualty clearing stations at 
Achiet-le-Grand was also being prepared at Miraumont, in 
the event of ambulance trains being prevented by hostile 
fire from coming up to Achiet-le-Grand. All these positions 
were within ten or twelve miles of the front line, except Edgehill, 
which was some twenty-three miles back. Schemes, however, 
were drawn up for their retirement. The D.M.S. of the Third 
Army regarded his first line of casualty clearing stations as 
those at Beaulencourt, Grevillers and Achiet-le-Grand, his 
second line as Edgehill, to which the casualty clearing stations 
at Beaulencourt would retire, and Aveluy, for those withdrawn 
from Achiet-le-Grand and Grevillers. Le Bac du Sud and 
Agnez-les-Duisans were also regarded as second line positions, 
although somewhat far forward. His third line consisted 
of the stationary hospitals at Doullens, Frevent and St. Pol. 
Although, therefore, in the distribution of casualty clearing 
stations too many were in a forward area, complete schemes 
were ready for their withdrawal in the event of a retirement. 

The D.M.S. of the Third Army appears to have had some 
anxiety regarding the group of casualty clearing stations at 
Agnez-les-Duisans as a second line group, and each of the 
three casualty clearing stations there had been instructed to 
prepare in minute detail measures for falling back rapidly 
either on Aubigny or St. Pol. Indeed all the casualty clearing 
stations of the Third Army had prepared detailed schemes 
for withdrawal to the third line at Doullens, Frevent or St. Pol. 

The First Army. — The First Army casualty clearing stations 
in March 1918, were at Ruitz, Nos. 1 and 4 Canadian, Nos. 6 
and 15 ; Chocques, No. 1 ; Bruay, No. 22 ; Lapugnoy, No. 18 ; 
Lozinghem, No. 23 ; Merville, Nos. 51 and 54 ; St. Aubin, 



208 MEDICAL HISTORY OF THE WAR 

Nos. 30 and 57 ; Lillers, No. 58 ; Haverskerque, No. 33 ; 
Aubigny, No. 42. Those at St. Aubin were clearly too far 
forward and the D.M.S. of the Army was instructed by the 
D.G.M.S. to move them back. Consequently No. 57 had 
already been brought back to Aubigny by the 18th March. 

The Fourth Army. — Those of the Fourth Army were at 
Oultersteene, No. 2, No. 1 Australian and No. 2 Australian, 
the last having been brought back from Trois Arbres on the 
15th March ; Dozinghem, No. 4 ; Remy Siding, Nos. 10, 17, 
2 Canadian and 3 Canadian ; Godewaersvelde, No. 11 ; 
Arneke, No. 13 ; Ebblinghem, No. 15 ; Rousbrugge, No. 36 
from the Dunkirk area ; Nine Elms, No. 44 and No. 3 
Australian; Bandaghem, Nos. 62 and 63. 

The sketch map shows the relative positions of the 
casualty clearing stations to the front line. The interrupted 
line on the map indicates the limit of what the D.G.M.S. 
considered to be the forward zone beyond which casualty 
clearing stations should not be placed in a situation of defence 
in view of the possibility of the line being forced back. 

Divisional and corps medical arrangements were generally 
the same as during the periods of trench warfare and the 
battles of 1917, but with elaborate arrangements for corps 
rest stations and scabies centres in back areas and for treating 
gas casualties in front areas. 

Schemes had been prepared for advanced and main dressing 
stations to fall back to new positions in the event of a retirement, 
the general arrangement being for the advanced dressing 
stations to fall back on main dressing station positions and 
the latter on casualty clearing station positions, but, as will 
be seen, in the case of the Fifth Army the policy was to 
eliminate main dressing stations and evacuate direct from 
advanced dressing stations to casualty clearing stations. 

Outline of the operations. 

This then was the medical situation prior to the German 
offensive. The attack was opened on the 21st March, shortly 
before 5 a.m., by " a bombardment of great intensity, with 
gas and high explosive shells from all natures of artillery and 
trench mortars." * It was launched against the whole of the 
Third and Fifth Army fronts, " while road centres and railways 
as far back as St. Pol were engaged by high velocity guns." 
Other fronts were also subjected to bombardments and to gas 

* Sir D. Haig's despatches, p. 186. 



GERMAN OFFENSIVE IN 1918 



209 



attacks, but the chief offensive was confined to the front 
between the Sensee, south of Arras, and the Oise. 

The Fifth Army front on the British right was held by the 
Illrd, XVIIIth, XlXth and Vllth Corps, with the Cavalry 
Corps in reserve. Their respective D.Ds.M.S. were Colonels 
V. Prynne, H. I. Pocock, E. W. Slayter 



S. Macdonald, H. 

and F. J. Morgan. 

The divisions in 

to left as follows 



line with their A.Ds.M.S., were from right 



Illrd 
Corps 



'58th Division Colonel J. W. H. Houghton, 

A.D.M.S. 

18th „ Colonel J. Poe, A.D.M.S. 

14th ,, Colonel J. H. Campbell, 

A.D.M.S. 



XVIIIth 
Corps 



'36th Division 
30th 

61st 



Colonel 
Colonel 



H. 
J- 



Colonel C. 



S. Roch, A.D.M.S. 
D. Alexander, 

A.D.M.S. 
H. Howkins, 

A.D.M.S. 



'24th Division Colonel F. R. Buswell, 
XlXth J A.D.M.S. 

Corps | 66th „ Colonel J. Mackinnon, 

A.D.M.S. 



Vllth 
Corps 



16th Division Colonel A. W. N. Bowen, 

A.D.M.S. 

21st „ Colonel C. W. Profeit, 

A.D.M.S. 
9th „ Colonel O. W. A. Eisner, 

A.D.M.S. 



In reserve were the 2nd, 3rd and 1st Cavalry Divisions, 
with Colonels A. H. Safford, J. Powell and T. C. Mackenzie as 
their A.Ds.M.S., at Guiscard, Athies and Peronne respectively ; 
the 20th Division, Colonel B. F. Wingate, A.D.M.S. ; 50th 
Division, Colonel A. Milne-Thompson, A.D.M.S. ; and the 
39th Division, Colonel G. W. Brazier-Creagh, A.D.M.S. 

The Third Army front was held by the Vth, IVth, Vlth and 
XVIIth Corps, whose respective D.Ds.M.S. were Colonels 
O'Callaghan, Pollock, Hinge and Bray. 

Ten divisions in line on the Third Army front were the 
47th, 63rd and 17th of the Vth Corps, the 51st and 6th of the 



210 MEDICAL HISTORY OF THE WAR 

IVth Corps, the 59th, 34th and 3rd of the Vlth Corps, and the 
15th and 4th of the XVII th Corps. The 56th Division of the 
XHIth Corps of the First Army was on the left of the 4th 
Division ; and the 2nd, 19th, 25th and Guards Divisions were 
in close reserve, with the 41st Division from Itafy and the 
40th Division further back, and the 31st Division marching south 
to the Third Army area from Frevillers in the XHIth Corps area. 

Between the 21st and 23rd March, the Fifth Army front had 
retired from its battle zone, after severe fighting, to a line 
running from the Oise at Viry-Noreuil northwards to the 
Somme Canal, west of Ham, then along the Canal to west of 
Peronne and thence north of the Somme to the east of Sailly- 
Sallisel. 

The Third Army had retired at the same time to a line 
running from the Fifth Army left to the east of Ytres and 
thence roughly in a north-easterly direction, west of St. Leger, 
to Boyelles, from which point it ran east of Arras to Fampoux 
on the Scarpe. 

In the earliest phases of the attack, therefore, the positions 
of the casualty clearing stations at Cugny, Ham, Peronne la 
Chapellette, Ytres and Boisleux-au-Mont, were either in the 
enemy's hands or in the front line of battle. 

On the 24th March, the Third Army line retired to a new 
line running from Boyelles southwards, west of Bapaume 
through Longueval to the Somme between Curlu and Clery. 
The Fifth Army line followed the Somme from there to the 
east of Marchelepot, but from that point southwards the line 
ran considerably west of the Somme, which the enemy had 
crossed at Ham and elsewhere, to the Oise between Chauny 
and Abbecourt. The part of the line from the Oise to a point 
about five miles south of Nesle was taken over by the French 
troops at this time, and the Illrd Corps, which occupied the 
sector previously, came under the command of the French. 

On the 25th March, the line of the Somme south of Peronne 
was abandoned, and the casualty clearing station positions 
at Noyon and Marchelepot, and at Peronne la Chapellette 
fell into the hands of the enemy. North of the Somme the 
enemy pushed a salient into the Third Army line along the 
Ancre Valley from Achiet-le-Grand to Beaucourt-sur-Ancre 
arid thence through Thiepval, Contalmaison and Montauban 
to Curlu on the Somme. Consequently Achiet-le-Grand and 
Grevillers no longer existed as casualty clearing station positions. 

The retirement was continued on the 26th March by the 
Third Army, which straightened its line to positions along 
the Ancre to Albert and Dernancourt and thence south to 



GERMAN OFFENSIVE IN 1918 211 

the Somme opposite Chipilly, while the Fifth Army continued 
to hold the south bank of the Somme to a point opposite Bray. 
Its line from there ran south through Rozieres to some four 
miles west of Roye. The French line ran thence south-east 
to the Oise west of Noyon. By this retirement all the original 
casualty clearing station positions of the Third and Fifth 
Armies were in the front line or in the enemy's hands, with 
the exception of Agnez-les-Duisans. 

From the 26th March until the 5th April, when the German 
offensive against the Third and Fifth Armies ceased, the 
Third Army line remained practically unchanged, except that 
it was withdrawn west of Albert and Dernancourt and ran 
to the Somme at Sailly-le-Sec, the Vllth Corps operating 
north of the Somme being transferred to it from the Fifth 
Army. The Fifth Army was compelled to withdraw on the 
Somme to the point at which the Third Army line had stabilized 
on the north bank, but its line formed a salient from there to 
Rozieres and Arvillers, where it joined the French line, now 
withdrawn to the west of Montdidier. The line from there 
ran eastwards to the south bank of the Oise as far as the 
original position south of La Fere. 

On the 28th March the Rozieres salient was abandoned 
and the line of the Fifth Army then ran from Hamel through 
Marcelcave and Ignacourt to Mezieres, whence it was continued 
by the French to the line of the Avre. 

On the 29th and 31st March, the British line south of the 
Somme was shortened, and did not extend farther south than 
Hangard on the Luce. The French line was then withdrawn 
to the west of the Avre from Moreuil and Morisel through 
Grisvesnes to Ayencourt. Finally, by the 5th April, the British 
line south of the Somme was brought somewhat farther back 
to the west of Hamel and east of Villers Bretonneux, joining 
the French line at Hangard. 

From the afternoon of the 28th March the Fifth Army 
between the Somme and the Luce was taken over by General 
Sir H. Rawlinson, a reserve army under General Gough 
being formed for the construction of a new line of defences 
behind the armies engaged. On the 2nd April the Fifth Army 
was re-formed as the Fourth Army, Major-General B. M. 
Skinner carrying on the duties of D.M.S., until the 8th April, 
when Major-General O'Keeffe rejoined it from the Second 
Army as D.M.S. Major-General Guise Moores then succeeded 
Major-General O'Keeffe as D.M.S. of the Second Army. 

The medical situation during the offensive against the 
British is recorded in the following chapters. 



CHAPTER XIII. 

THE GERMAN OFFENSIVE AGAINST THE FIFTH ARMY IN 1918. 

IN the preliminary arrangements for the defence of the Fifth 
Army front, the possibility of the line being driven back 
beyond the sites of the casualty clearing stations does not 
appear to have been fully realized. In fact the D.M.S. displayed 
a tendency to prepare as much for an advance as for a retreat. 
He was apparently reluctant to abandon the extensive surgical 
work which had been practised so successfully by his casualty 
clearing stations in the battles of Ypres in 1917. Obviously, 
however, such work would be impossible during a retreat, 
at any rate in forward C.C.Ss., as was indicated in the D.G.M.S. 
instructions of 6th March 1918. 

On the 26th February the D.M.S. of the Fifth Army had 
issued a series of instructions for medical arrangements in 
the event of an advance or a retirement, and had asked the 
D.A. & Q.M.G. of the Army if he could be provided in an 
emergency with one hundred lorries to move a casualty clearing 
station from Tincourt in one day, thus showing that there 
was no intention to move from this dangerously advanced 
position except at the last moment, and at a time when a 
move of the nature contemplated would be fraught with 
difficulty. Again, on the 28th February, he ordered the 
casualty clearing stations at Tincourt to indent for more 
hospital marquees in order to increase their accommodation, 
thus adding to the bulk of equipment that would require 
removal. 

On the 2nd March, at a conference of Ds.M.S. of Armies 
held at the D.G.M.S. office by the D.D.G., the D.M.S. of the 
Fifth Army was warned that his casualty clearing stations 
might be lost in the event of a sudden attack, but he then 
expressed a hope that he would get them away complete in 
good time, as he had asked for trains to be ready to remove 
the units as soon as danger was foreseen. Here, again, the 
mistake was being made of waiting until the actual danger 
occurred to bring back casualty clearing stations in dangerously 
forward positions, and then arranging not for a mobile section 
to be moved, such as would require only eight or nine lorries 
and would be capable of being got ready for work immediately 



MOVEMENT OF CASUALTY CLE ARING STATIONS OF FIFT H_ARMY DURIN GjgR MAN OFFENSIVE, ggRING OF 1918. 

m 




GERMAN OFFENSIVE AGAINST FIFTH ARMY 213 

in a new site, but for the whole bulky unit to be moved back 
at one time, requiring a complete train or a hundred or more 
lorries, both uncertain transport during a sudden retirement. 
Further, when No. 38 CCS. from Italy was being brought 
into the Fifth Army area, the site suggested for it by the staff 
of the Army on the 12th March was Bray, but to this the 
D.M.S. objected as being too far back. It was consequently 
sent instead to Maricourt Plateau. 

As might have been expected such arrangements were 
bound to lead to much loss of equipment, with resulting 
inadequate arrangements in back areas, in the event of a 
retreat ; and this was what actually happened. Fortunately, 
however, all the wounded, and they numbered many thousands, 
who were brought back to the casualty clearing stations, 
were evacuated and the personnel also got away before the 
units were captured by the enemy. 

The Casualty Clearing Stations. 

The functions and accommodation of the casualty clearing 
stations of the Fifth Army as detailed by the D.M.S. of the 
Army, before the German attack, are shown in the following 
table. 



Medical Units. 


Area. 


Accommo- 
dation for 
wounded. 


Gailly. 

No. 41 Stationary- 
Hospital. 


All sick from Proyart and Boves areas 
north of Amiens road and from Bray 
area. 

Infections from Bray, Proyart and Boves 
areas. 

N. Y.D.N 

Self-inflicted wounds 

Ear, Throat and Nose special cases 


> 1,000 


Tincourt. 
Nos.5&55C.CSs. 

No. 5 CCS. 
No. 55 CCS. 


All battle casualties from Vllth and 

XlXth Corps. 
Acute and urgent medical cases (excluding 

Infectious) from Vllth and XlXth 

Corps areas. 
Gassed cases of Vllth and XlXth 

Corps. 


> 2,000 


La Chapelette. | 

Lucknow CCS. . . j All Indians — sick and wounded 


600 



214 



MEDICAL HISTORY OF THE WAR 



Medical Units. 


Area. 


Accommo- 
dation for 
wounded. 


Marchelepot. 

Nos. 32 & 34 C.C.Ss. 

No. 32 CCS 

No. 34 CCS. . . 


All sick from Training Area, north of 
Warvillers — Freniches line, and sitting 
sick from XlXth and Vllth Corps 
front areas. 

Dysentery and Dysenteric Diarrhoea 

Eye Centre . . . . . . 

Dental Centre 

Infectious from areas east of Bray and 
Proyart areas and south of Proyart 
area. 

Injuries to Skull from front as far south 
as Holnon. 


► 2,000 


Ham. 

No. 61 CCS. . . 


All battle casualties and sick from XVIIIth 
Corps north of St. Quentin-Somme 
Canals and from Ercheu area, east of 
Somme-Noyon Canal. 


1,000 


Cugny. 

No. 41 CCS. . . 


All battle casualties and sick from XVIIIth 
Corps south of St. Quentin Canal to 
Tugny, and thence to Dury, Sommette, 
Bronchy and Le Plessis inclusive, 
and Illrd Corps north of line Ber- 
lancourt - La Neuville - Liez - Vendeuil 
inclusive. 

Gassed cases from Illrd and XVIIIth 
Corps. 


► 1,000 


Noyon. 

No. 46 CCS. and 
Advanced Op- 
erating Centre 
at Abbecourt. 


All battle casualties and sick south of 
Vendeuil-Liez-La Neuville-Berlancourt 
and Southern boundary of Ercheu 
area ; also from Guiscard and Noyon 
areas. 

Abdominal injuries from this area to 
advanced operating centre, Abbecourt. 


> 1,200 


Roye. 

Nos. 50 & 53 C.C.Ss. 


All sick from Rollot, Montdidier, Training 
Area south cf line Warvillers-Freniches 
(inclusive), Roye-Solente and Ercheu 
(west of Somme-Noyon Canal) areas. 


2,000 


Rozibres. 

No. 47 CCS. . . 


All sick from Proyart and Boves area 
south of Amiens road. 


1,000 



GERMAN OFFENSIVE AGAINST FIFTH ARMY 215 

Immediately after the German offensive was launched the 
two casualty clearing stations at Tincourt were ordered by 
the D.M.S. to close for admissions at 8 a.m. on the 21st March, 
but only No. 5 was ordered to strike tents and pack equipment 
at once and prepare to move. The officer commanding No. 55 
C.C.S., however, decided to do so without waiting for orders, 
and by noon all the patients, except one unfit to be moved, 
were evacuated by ambulance train. The nursing sisters of 
both units and the surgical teams of No. 5 were sent to work 
in Nos. 32 and 34 C.C.Ss. at Marchelepot, the same afternoon, 
while the surgical teams of No. 55 went to No. 61 CCS. at 
Ham. The equipment of No. 5 was loaded on goods trains 
during the evening and was taken to Rozieres, where it com- 
menced to open the following morning. The equipment of 
No. 55 was hurriedly loaded on a train during the night and 
all but a small amount was saved and brought to Rozieres, 
where the unit was established alongside No. 5. However, 
before the camps were ready to receive wounded at Rozieres, 
all work was stopped there on the 24th March. The personnel 
of No. 5 was then ordered to proceed to No. 42 Stationary 
Hospital, Amiens, on the 26th March, to Namps on the 27th, 
and to Picquigny the same afternoon, where it opened in build- 
ings, obtaining drugs, dressings and equipment by local 
purchase. The surgical teams of No. 55 CCS. rejoined their 
unit at Rozieres during the night of the 22nd/23rd, having 
left Ham hurriedly on foot without their kits or operation- 
room equipment. Some of the stores of the unit were loaded 
on trucks on the evening of the 24th March, and on the 
following day a site was selected at Hargicourt as an entraining 
centre for wounded. The stores of No. 55 CCS. arrived 
there at 5 p.m., and two hours afterwards wounded began to 
arrive in large numbers from the Roye group of casualty 
clearing stations. At 8 p.m. the nursing sisters also arrived 
from Roye. The unit was now out of touch with the D.M.S. 
and the commanding officer sent several of the nursing sisters 
to No. 42 Stationary Hospital, Amiens. By 4 p.m., on the 
26th March the remainder of the stores and personnel arrived 
at Hargicourt from Rozieres, and ambulance trains came up 
during the afternoon. At 1 a.m. of the 27th March orders 
reached the unit from the D.M.S. to move to Namps. All 
the wounded were cleared by 9 a.m. in ambulance trains and 
the bulk of the stores were taken to Namps by lorries. During 
its stay at Hargicourt, 1,352 sick and wounded were admitted 
to No. 55 CCS. On its arrival at Namps it opened alongside 

10134 R 



216 MEDICAL HISTORY OF THE WAR 

No. 41, which had already arrived there from Cugny. Orders 
were given to it to pack up and be ready to move by 10 a.m. 
on 30th March, but it remained parked at Namps till the 
4th April, when it was moved to Longpre. 

No. 61 CCS. was ordered out of Ham at 3 p.m. on the 22nd 
March. All patients were evacuated by 1 a.m. on the 23rd 
and the personnel proceeded to Rozieres, and assisted in the 
work of No. 47 CCS. there. It was only by the personal 
efforts of the D.A.D.R.T., who arrived for the purpose of 
evacuating the railhead at Ham at 4 o'clock in the afternoon 
of the 22nd March, that No. 6 Ambulance Train was brought 
up and loaded with the assistance of fifty or sixty men of 
No. 28 Area Employment Company. Owing to the line being 
cut, it was not possible to bring the train to the ambulance 
train siding, and the patients had to be carried to a point on 
the line about a quarter of a mile farther back. The wounded 
were eventually entrained and evacuated under enemy 
artillery fire. The equipment and stores were abandoned. 
On the 27th March the personnel was attached to No. 42 
Stationary Hospital, Amiens, and on the following day went 
to Namps and formed an entraining centre there. The 
commanding officer Lieut. -Colonel C H. Turner, had been sent 
to Villers Bretonneux and was in charge of an entraining centre 
at the railway station there between the 23rd and 27th March ; 
on rejoining his unit, he was put in charge of the entraining 
centre at Namps. 

Orders to close No. 41 CCS. at Cugny were received at 
6.50 a.m. of the 21st March. All patients were to be evacuated 
by ambulance train about 11 a.m., but the line was cut, and they 
were consequently sent by car and lorry to No. 61 CCS. at Ham, 
to which also the nursing sisters and surgical teams were sent 
by orders of the D.M.S. At 5.45 p.m. orders to move to Roye 
arrived. Lorries were kept busy removing stores to Roye all 
night, but at 10.45 a.m., the enemy being within three miles of 
the unit, the personnel were sent off by road and the remaining 
equipment abandoned. Although attempts were made to salve 
some of it the lorries were unable to get beyond Ham. At Roye 
the personnel was distributed to the casualty clearing stations 
there, and also to the entraining centre at Villers Bretonneux. 
On the 24th March the unit was ordered to Vecquemont, but 
the stores had been sent to Moreuil, where schools were taken 
over and equipped. Such stores as had been taken to Vec- 
quemont were also brought back to Moreuil on the night 
of the 25th/26th. On the 27th the unit was moved to Namps, 



GERMAN OFFENSIVE AGAINST FIFTH ARMY 217 

dumping part of the stores midway between that place and 
Moreuil. It remained at Namps till the 22nd April, receiving 
and treating most of the casualties brought there. Between 
the 27th March and 2nd April the records of the unit give the 
following statistics : — 



Date. 


Admitted. 


Evacuated. 


Died. 


Remaining. 


27th March 


2,080 


440 by road 


8 


1,920 


28th 






1,332 


2,323 


29 


429 


29th 






2,791 


1,464 


25 


735 


30th „ . 






2,641 


2,681 


38 




31st 






1,780 


2,054 


35 


65 


1st April 






1,212 


1,014 


30 


168 


2nd „ 


502 


584 


— 


55 



The Lucknow CCS. commenced to move from Peronne la 
Chapellette to Maricourt Plateau on the 22nd March. At first 
only one section was ordered there, but at 11 p.m. the second 
section was ordered to move by the D.M.S. There were only 
two lorries available for transport, and as it took six hours to do 
one return journey it was calculated that twenty-four hours 
would be required to move a section. At 1.30 p.m. on the 
23rd March machine guns came into action near the hospital, 
and at 2 p.m. the commanding officer and the remainder of the 
personnel set off across country, reaching Maricourt about 8 p.m. 
Lorries returned about 2.30 p.m. but came under heavy fire and 
two drivers were wounded. The equipment still left at Peronne 
la Chapellette was consequently abandoned. From this time 
the unit was guided in its work chiefly by the officer commanding 
No. 38 CCS., who informed it at 3 a.m. on the 24th March that 
the enemy was approaching. An officer was despatched to 
obtain instructions from the D.M.S. As communication with 
the D.M.S. appeared hopeless the officer commanding retired 
with his personnel to Corbie. After reaching Corbie he reported 
his arrival to the D.M.S. and was placed under arrest for leaving 
Maricourt without orders and before clearing his patients* A 
party from the British personnel of the unit then returned to 
Maricourt and with the aid of a few cars of No. 10 M.A.C 
completed evacuation of the patients, who were taken to Villers 
Bretonneux by 3 a.m. of the 25th March. The unit was then 
ordered to Vecquemont, but failed to salve all the equipment 



He was subsequently released. 



218 MEDICAL HISTORY OF THE WAR 

left at Maricourt. It then came under orders of the D.M.S., 
Third Army, and was moved to Pont Remy near Abbeville on 
the 29th March. 

No. 38 CCS. detrained at Maricourt Plateau from Italy on 
the 19th March, and commenced to open at once. Accommo- 
dation for 400 was ready on the 21st and 17 nursing sisters were 
sent to it on the 22nd. It received 1,105 wounded on the 22nd, 
1,204 on the 23rd and 73 on the 24th, evacuating all by 
ambulance trains or temporary ambulance train except 10 
moribund cases, before it received orders on the 24th to close 
and move to La Neuville near Corbie, where it opened under the 
command of the D.M.S., Third Army, the following day. Forty 
lorry loads of stores were got away during the 24th and night of 
the 24th/25th March, but about half the tentage had to be 
abandoned. 

After Tincourt, Ham and Cugny had been abandoned, 
Marchelepot, Noyon and Roye became the chief centres to 
which wounded were sent during the first three days of the 
battle, more especially Marchelepot, to which all the surgical 
teams from the lines of communication, ten in number, had 
been brought by the D.M.S. Arrangements for taking the 
teams over at No. 42 Stationary Hospital, Amiens, and dis- 
tributing them on their arrival there in cars of the Army had 
not been made according to the instructions issued by the 
D.G.M.S. on the 6th March.* Consequently they were kept 
at Amiens during the whole of the day of the 21st March, 
having arrived there in cars driven by women drivers from the 
bases. Operative surgery, however, had to be reduced to a 
minimum at Marchelepot, as both of the casualty clearing 
stations, Nos. 32 and 34, were crowded with wounded, who 
had to be got ready for immediate evacuation, and the per- 
sonnel had to devote their whole attention to this. The O.C 
of No. 32 CCS. left Marchelepot on the 23rd March, on his 
own initiative, with his personnel and 96 patients owing to the 
heavy shelling in the neighbourhood, the cutting of the railway 
communications, and the possibility of heavy fighting in the 
vicinity. He handed over his patients to No. 41 Stationary 
Hospital at Gailly and was ordered to Namps by the D.M.S. 

* The D.M.S. of the Fifth Army informed the D.G.M.S. office by telephone 
on the morning of the 21st March that the teams would be sent to the C.C.Ss. 
by the cars in which they would arrive from the base, but, as the drivers of 
these cars were women, who did not know the roads and whom the D.G.M.S. 
expressly wished to go no farther forward than Amiens, the teams were 
detained at Amiens until suitable arrangements for distributing them to the 
C.C.Ss. had been made by the Army D.M.S, 



GERMAN OFFENSIVE AGAINST FIFTH ARMY 219 

on the 25th March. The stores and equipment at Marchelepot 
were abandoned. No. 34 CCS. remained until the last of 
the wounded had been evacuated by ambulance train, tem- 
porary ambulance train and car and then hurriedly departed 
in a temporary train at 9.45 p.m. on the 23rd March, with 
only a small quantity of operating room equipment, the 
army ophthalmic centre equipment, and the office records. 
The remaining stores were abandoned. The personnel and 
such stores as had been saved were ordered to the entraining 
centre at Villers Bretonneux. The unit was sent on to Namps 
on the 25th March. 

The D.M.S. of the Army was not satisfied with the casualty 
clearing stations leaving Marchelepot without orders from 
him, but there was lack of communication and the railway 
staff feared that the line would be broken and no further trains 
possible. Between 5,000 and 6,000 wounded passed through 
the two casualty clearing stations there on the 21st, 22nd and 
23rd March, and all were got away before the enemy arrived. 

After Marchelepot was abandoned, wounded were directed 
to Rozieres, where No. 47 CCS. was established, reinforced by 
the personnel of Nos. 5 and 55 C.C.Ss. from Tincourt, nursing 
sisters of No. 61 CCS. from Ham, and surgical teams from 
various units. Wounded began to arrive at Rozieres at 
8.45 a.m. of the 22nd March and continued arriving in a 
steady stream till the 26th, when orders came for the CCS. 
to retire. The wounded were then sent to No. 41 Stationary 
Hospital, Gailly, and to the entraining centre at Villers 
Bretonneux. Some twenty of the patients had to be carried 
at the last moment by hand as far as Harbonnieres. All the 
operating instruments and surgical team equipment were 
saved and taken to Amiens, but the remainder of the stores 
was abandoned. On the 27th March No. 47 CCS. went 
to Namps. 

The casualty clearing stations in the southern sector, No. 46 
at Noyon, and Nos. 50 and 53 at Roye, were cut off for 
some time from telephone communication with the D.M.S. 
Consequently the D. D.M.S. of the Illrd Corps gave instructions 
for Noyon to be cleared on the 24th March, but a message 
reached No. 46 CCS. at 10 p.m. from the D.M.S. ordering 
the unit to remain, as the military situation, so the message 
said, was much better. However, at 4 a.m. of the 25th another 
message came through to send the nursing sisters to Amiens. 
There were then some 1,500 wounded in the casualty clearing 
station. Several hundred walking wounded broke away from 



220 MEDICAL HISTORY OF THE WAR 

the unit and followed some lorries which had been placed at 
the disposal of No. 46 Casualty Clearing Station by the French. 
By the help of these lorries, twenty-four ambulance cars, two 
journeys of No. 22 M.A.C. and a train, the whole of the patients 
were got away on the 25th March to Hargicourt before the 
Germans arrived. The personnel was ordered to Picquigny 
on the 27th March, but very little equipment had been salved. 
The work of this casualty clearing station at Noyon was 
particularly heavy, over 5,500 wounded being admitted between 
the 21st and 25th March. At one time, on the 24th March, 
nearly 3,000 wounded were in the unit. Many had to be 
accommodated on the ground in the open air, but the weather 
was fortunately fine and blankets and ground sheets were 
abundant. 

The two casualty clearing stations at Roye remained there 
until the 26th March, when the place was evacuated under 
enemy fire and the personnel transferred to Hargicourt. 
Wounded had been arriving in large numbers owing to the 
closing of the casualty clearing stations in more advanced 
positions, but they were all cleared by motor cars, lorries, 
artillery limbers, and any available transport passing to the 
rear. Many were also cleared by No. 22 M.A.C. No trains 
had reached Roye after 4 p.m. on the 25th March. The 
nursing sisters had been sent to Hargicourt on the night of 
the 23rd/24th March. They and the rest of the personnel 
went to Namps on the 27th March. The equipment of the 
units had been abandoned and the personnel, while at Namps, 
assisted in the work of No. 41 CCS. 

During these movements of the casualty clearing stations 
of the Fifth Army a large entraining centre was established 
under Lieut. -Colonel Turner, the officer commanding No. 61 
CCS., at Villers Bretonneux, and another at Roye under 
Lieut. -Colonel Edwards, commanding No. 41 CCS., from the 
23rd to the 26th March, when the entraining centres were 
transferred to Namps and Hargicourt. Namps eventually 
became the locality at which all the casualty clearing stations 
with such equipment as had been salved were concentrated, 
except No. 5 and No. 46, which went to Picquigny on the 
Somme, between Amiens and Abbeville. The equipment at 
Namps was pooled and used by No. 41 and No. 55 C.C.Ss. which 
were opened for the reception and treatment of wounded. 
The personnel of Nos. 50 and 53 C.C.Ss. was attached for 
duty in them. No. 61 CCS. personnel, assisted by the 
personnel of Nos. 32 and 34, formed an entraining and 



GERMAN OFFENSIVE AGAINST FIFTH ARMY 221 

evacuating centre, and the whole of the units in Namps 
were placed under the direction of Lieut. -Colonel Turner, as 
Senior Medical Officer. 

A subsidiary entraining centre was formed at Montieres 
on the 28th March, and No. 47 CCS. was sent there. 

No. 4 CCS. was transferred complete from Dozinghem in 
the Ypres area to reinforce the Fifth Army, the D.M.S. 
allotting it to Vecquemont, but when the area north of the 
Somme came under the Third Army it was left there in the 
trucks pending its movement to another site. 

No. 41 Stationary Hospital was moved from Gailly to 
Amiens on the 26th March and took over the buildings and 
equipment of No. 42 Stationary Hospital. It left Amiens, 
however, two days later for Fouilloy. 

The general position and movement of the casualty clearing 
stations of the Fifth Army during the German offensive may 
be followed by reference to the sketch map. 

It would appear from this record of the movements of the 
casualty clearing stations in the Fifth Army that there was no 
clear indication beforehand of the positions to which they 
could usefully be withdrawn. In fact during the last week of 
March the D.M.S. or his staff were engaged in searching for 
suitable sites, instead of having had them already marked down 
for successive retirements. But, disregarding these defects in 
medical strategy, there stands out the one great fact that, owing 
to the energy and initiative of all ranks, no patient admitted 
to a casualty clearing station of the Fifth Army was abandoned 
and all, except those who died before evacuation, were got 
away. 

The mobile laboratories were all moved back during the 
offensive without loss of equipment, but of the two advanced 
depots of medical stores all the stores of No. 13 were 
abandoned at Ham and most of the stores of No. 14 
at Peronne la Chapellette. No. 18 Advanced Depot was 
consequently transferred from the Second to the Fifth Army 
on the 27th March and went to Namps, but was immediately 
moved back to Fouilloy and then to Longpre. 

The Medical Services with Corps. 
The medical services of the corps and divisions of the 
Fifth Army worked smoothly and well, and the retirement 
of regimental aid posts, advanced and main dressing 
stations, which successively fell back on one another, appears 
to have presented no difficulty. 



222 MEDICAL HISTORY OF THE WAR 

The Illrd Corps. — The headquarters of the Illrd Corps 
were at Ugny-le-Gay on the 21st March with No. 24 M.A.C 
attached to it. Battle stations had been organized beforehand, 
and successive zones of withdrawal defined. On the 23rd 
March the D.D.M.S. (Colonel S. Macdonald) had withdrawn 
to Noyon, and, as the corps was then retiring in the direction 
of the French area, he took, on his own initiative, control of 
the casualty clearing stations at Noyon and Roye. Wounded 
of the corps were being evacuated from these casualty clearing 
stations to French hospitals at Compiegne. Colonel Macdonald 
established a dressing station at Royallieu and made arrange- 
ments with the French for the reception of British wounded 
into their hospitals. Field ambulances were consequently 
instructed to evacuate the wounded to Royallieu or from the 
northern sector of the Illrd Corps to the French hospital 
at Ressons-sur-Matz. The D.D.M.S. also arranged to draw 
dressings and drugs from French stores at Creil. Up to the 
29th March all wounded of the corps continued to be 
evacuated through the French hospitals. On that date the 
D.D.M.S. received instructions to evacuate them, if possible, 
to Namps. The corps rejoined the Fifth Army on the 30th 
March leaving, however, the 58th Division with the French. 
Up to that time many wounded officers and men of the Illrd 
Corps were cleared by French ambulance trains and distributed 
to French hospitals in the interior. They went to all parts of 
France. The particulars of each admission were sent by the 
French authorities to the British Military Attache in Paris, 
who sent the forms to D.G.M.S. at G.H.Q. Steps were then 
taken through the D.M.S., L. of C, to have the patients trans- 
ferred, as soon as their condition permitted, to British hospitals. 
The French records of each admission were then forwarded 
to the base record office at Rouen. 

There appears to have been no difficulty in the Illrd Corps 
in collecting and bringing the wounded during the retreat 
back to main dressing stations and C.C.Ss., and there is no 
record of a breakdown at any time. The policy of the D.D.M.S. 
was to distribute the cars of No. 24 M.A.C. to divisions, retaining 
a minimum reserve of twelve cars at the headquarters of the 
convoy under his own control. 

Arrangements were also made for a medical lorry park 
being formed of twenty-two lorries at Villequier Aumont, 
whence they were to be distributed under orders of the 
D.D.M.S. by the O.C. of No. 24 M.A.C. Some of these lorries 
were to be distributed to the walking wounded collecting 



GERMAN OFFENSIVE AGAINST FIFTH ARMY 223 

stations of the divisions for clearing the walking wounded to 
the corps rest station or to the casualty clearing station at 
Noyon. The O.C. of the medical lorry park was to be respon- 
sible for ensuring an adequate supply of lorries for rapid and 
smooth evacuation. 

Much of the success of the medical work of the corps appears 
to have been due to the D.D.M.S. having this medical lorry 
park placed at his disposal. The total number of lorries 
allotted to him was thirty, two each being sent, on the receipt 
of the orders to prepare for attack, to each of the four walking 
wounded collecting stations, while the remaining twenty-two 
were parked, as already noted, at the headquarters of the 
medical lorry park. 

Strong points in the battle zone were supplied with medical 
emergency boxes, which were not to be used except in the 
case of attack. They contained shell and field dressings, 
splints, bandages, cookers, with a certain amount of medical 
comforts, stretchers and Thomas' splints, and anti-tetanic 
serum. They were to be held as trench stores. Wounded 
were to be cleared from these strong points by the bearers 
detailed from field ambulances whenever the situation per- 
mitted, but on no account was the garrison allowed to be 
depleted for bringing them back. 

Between the 21st and 25th March there were many casualties 
in the R.A.M.C. of the corps, as shown in the following table : — 

Casualties in the R.A.M.C. of the Illrd Corps. 



Division. 


Killed. 


Wounded. 


Missing. 


Gassed. 


Total. 


Offs. 


O.R. 


Offs. 


O.R. 


Offs. 


O.R. 


Offs. 


O.R. 


14th Div. 
18th Div. 
58th Div. 


1 


9 

1 


1 
1 


22 
3 


1 

4 


57 
22 


— 


9 


91 

27 
13 


Total . . 


1 


10 


2 


25 


5 


79 


— 


9 


131 



The XV I Ilth Corps.— The XVIIIth Corps, which retired 
on the left of the Illrd Corps from Ham through Nesle to 
Moreuil between the 22nd and 25th March, and to St. Sauflieu 
on the 27th March, eventually handed over all its divisions to 
the XlXth Corps on the 29th March, and on the 2nd April 
was withdrawn from the battle front. The evacuation of 
its sick and wounded also worked smoothly and well. Field 



224 



MEDICAL HISTORY OF THE WAR 



ambulance transport, No. 31 M.A.C., and motor lorries con- 
veyed them in the direction of Noyon, Roye and eventually 
Hargicourt and Namps. In accordance with the instructions 
of the D.M.S. the advanced dressing stations were to be 
evacuated direct to the casualty clearing stations, and the 
D.D.M.S. of the corps consequently arranged for No. 31 M.A.C. 



DIAGRAM SHOWING THE FIRST AND SECOND SYSTEMS OF USING 
CARS OF N° 31 MOTOR AMBULANCE CONVOY WITH THE XVI||™ CORPS 



System N°- ! 



System N°- 2 




Q DIVISIONAL DRESSING STATIONS AND 
^f-^ WALKING WOUNDED COLLECTING. STATIONS 

MOVING FROM PLACE. TO PLACE 

/<j>V ADVANCED HEADQUARTERS OF THE 

¥& MOTOR AMBULANCE CONVOY 



♦ 



REAR HEADQUARTERS OF THE 
MOTOR AMBULANCE CONVOY 

CASUALTY CLEARING STATION 



V 

<T0 



to be reinforced by five of the motor cars of each division in 
the line and all but the Ford cars of the division in reserve. 
This worked well during the first day of the battle, but there 
was great difficulty afterwards in maintaining communication 
with the A.Ds.M.S. of divisions. The D.D.M.S. then reversed 
his policy, and on the 23rd March placed five motor ambulance 
cars of No. 31 M.A.C. and four motor lorries, each seating 



GERMAN OFFENSIVE AGAINST FIFTH ARMY 225 



twenty-five walking wounded, at the disposal of each A.D.M.S., 
leaving a reserve of cars and lorries with No. 31 M.A.C. to be 
sent out on request. These arrangements worked well, and 
when the casualty clearing stations were concentrated at 
Namps, a system of clearing the advanced dressing stations 
by relays was adopted. The motor ambulance convoy had 
a rear and advanced post ; when a loaded car went back an 
empty car was at once sent forward from the advanced post, 
and in order to make this system more effective the advanced 
post was established at a relay point, through which all cars 
coming back with wounded from the dressing stations passed 
on their way to the casualty clearing stations, as shown in the 
diagram of the earlier and later systems on the previous page. 
There is no record of the losses amongst the R.A.M.C. in 
this corps, and the records of the wounded admitted to its 
medical units are not complete, but the following table shows 
such figures as were noted at the time : — 
Summary of wounded admitted to medical units of XVIIIth 

Corps during the period 12 noon 2\st March 1918 to noon 

31st March 1918. 



Date. 






Officers. 


Other ranks. 


March 1918. 






21st to 22nd 






35 


789 


22nd to 23rd 






15 


151 


23rd to 24th 






10 


89 


24th to 25th 






22 


253 


25th to 26th 






6 


80 


26th to 27th 






14 


236 


27th to 28th 






26 


583 


28th to 29th 






20 


225 


29th to 30th 


. 




6 


191 


30th to 31st 






47 


683 


Totals 






201 


3,280 



The XlXth Corps. — The headquarters of the XlXth Corps 
were at Villers Carbonnel, south of Peronne and west of the 
Somme Canal on the 21st March. The medical arrangements 
made by its D.D.M.S. were similar to those of the XVIIIth 
Corps, and evacuation of wounded by ambulance cars and 
lorries worked smoothly. No. 10 M.A.C. was allotted to the 
corps. The chief point in the medical arrangements issued 
on the 20th March was in connexion with the use of lorries. 
Six were to work from Roisel, along the Roisel-Tincourt road, 



226 MEDICAL HISTORY OF THE WAR 

and as each lorry was capable of making six trips in twenty-four 
hours, the six lorries could make a total of thirty-six trips, 
carrying 720 patients in all. Similarly six more lorries were 
to work from Montigny, capable of making three trips each 
in twenty-four hours, carrying a total of 360 patients ; and 
twelve lorries to work from Vermand, making three trips each, 
carrying a total of 720 patients. A total of 1,800 walking 
wounded could be removed in this way in twenty-four hours. 

It was further calculated that the light railway would 
bring back some 500 patients from Montigny and Roisel to 
Tincourt in five journeys daily. 

The general arrangements in the XlXth Corps were for 
the casualties to be brought back from the regimental aid 
posts by hand carriage to the advanced dressing stations, 
and from the advanced dressing stations direct to casualty 
clearing stations by means of ambulance cars, light railway 
and lorries or buses. There were nine regimental aid posts, 
four on the left sector, two in the centre and three on the 
right sector. 

The field ambulance posts were established at the following 
places just before the attack : — 

Advanced dressing stations : — 

Templeux and Roisel for the left sector. 
Jeancourt for the centre. 
Vermand for the right sector. 

Walking wounded collecting posts : — 

Templeux and Roisel for the left sector. 
Montigny Farm for the centre. 
Vermand for the right sector. 

Gas Centres on left and right sectors at the A.D.Ss. 

Gas Treatment Centre at Bernes. 

Corps Rest Station and Scabies Station at Doingt. 

Evacuation was to Tincourt for lying cases, Marchelepot 
for walking wounded and head cases, and Gailly for N. Y.D.N. 
and self-inflicted injuries. 

Thirty lorries or buses for twenty sitting cases each were 
supplied by the XlXth Corps, six, or a total of eighteen, being 
allotted, as noted above, for collecting from each of the walking 
wounded posts ; one was allotted to the gas centre at Bernes ; 
and the remainder were parked as a corps reserve at Cartigny. 

A light railway to Tincourt was to have brought the wounded 
back to the casualty clearing stations there from the northern 
sector of the corps ; but the closing of these casualty clearing 
stations immediately after the attack upset the arrangements, 



GERMAN OFFENSIVE AGAINST FIFTH ARMY 227 

and the wounded had then to be taken by road to Marchelepot, 
which in its turn was closed for casualties of the XlXth Corps 
on the first day, Rozieres being assigned for their reception 
after the 21st. 

The D.D.M.S. moved back to Foucaucourt on the night 
of the 22nd/23rd March and on the 24th to Harbonnieres. 
An attempt was made by him to salve the equipment of the 
casualty clearing stations at Marchelepot on the 24th under 
orders from the D.M.S. of the Fifth Army, but lorries were 
refused for this purpose, as the enemy was approaching the 
place and it was reported to be in flames. On the night of the 
24th/25th March the casualty clearing stations at Rozieres 
were closed and wounded of the corps were then sent to Villers 
Bretonneux, the corps headquarters moving there on the 
25th. On arrival at Villers Bretonneux the D.D.M.S. found 
3,000 wounded, chiefly walking cases, and endeavoured to 
expedite the arrival of ambulance trains. Villers Bretonneux 
and No. 41 Stationary Hospital at Gailly, which was also 
receiving wounded of the corps, were closed by the D.M.S. 
of the Army, who instructed the XlXth Corps D.D.M.S. on 
the morning of the 26th March to send his stretcher cases 
to Amiens and walking cases to Hargicourt until 8 a.m. of 
the 27th March, after which time all casualties were to go to 
Namps. 

On the latter date at 11.35 a.m. the D.D.M.S. of the XlXth 
Corps received a message from the D.M.S. ordering him to 
make medical arrangements for the force afterwards known 
as Carey's force, which had been hurriedly formed of con- 
valescents and others to hold a line between Villers Bretonneux 
and the Somme. The 2/2nd Northumbrian Field Ambulance 
of the 50th Division was consequently attached to the force. 
The officer commanding this ambulance sent his wounded to 
Villers Bretonneux station on the 27th, and had arranged 
with the Railway Transport Officer there to load them on 
an empty ammunition train under the charge of a medical 
officer and some other ranks. Unfortunately this train was 
sent to the base instead of to Namps. This appears to have 
been the only instance of wounded being sent back in a supply 
train to the base during this period. Subsequently the XlXth 
Corps held the line in front of Amiens between the Somme 
and the Luce, until withdrawn by the middle of April to a 
back area. 

The Vllth Corps. — The Vllth Corps headquarters, which 
had been at Templeux-la-Fosse, moved back on the night 



228 MEDICAL HISTORY OF THE WAR 

of the 2 1st /22nd March to Maricourt and the following day 
to Corbie. The 39th and 16th Divisions, however, retreated 
to the south of the Somme and joined the XlXth Corps, 
while the Vllth Corps was placed under the Third Army. 
Two Australian divisions joined it at the end of March and it 
was relieved on the 6th April by the Australian Corps and went 
to a back area of the Third Army. When the D.D.M.S. 
came under the Third Army administration he was instructed 
to send his wounded to the stationary hospitals at Gailly 
and Amiens, as the casualty clearing stations in the Third 
Army were all moving at the time and the casualties of the 
Army were being sent to Doullens. 

Twenty lorries had been lent by the Third Army to the 
corps for clearing walking wounded, but they were taken 
away on the night of the 31st March without reference to 
the D.D.M.S. or Corps Headquarters. This upset the whole 
scheme of evacuation of walking wounded. The D.D.M„S. 
was able, however, to keep back five of the lorries, and was 
promised more in the event of active operations again starting. 
He was much harassed by this interference with his arrange- 
ments and at not being able to count on their holding good 
for more than a day or so at a time. 

While the Vllth Corps was in the Fifth Army, forty lorries, 
together with No. 3 M.A.C, were placed at the disposal of 
the D.D.M.S. in anticipation of the attack. The lorries were 
to be distributed as thought necessary by the O.C. of No. 3 
M.A.C. Consequently, at the commencement of the operations, 
the ambulance cars of the convoy were distributed as follows : — 
24 ambulance cars to a dressing station at V.18.C, and 
20 to a dressing station at Villers Faucon. 
2 cars to a W.W.C.P., at Longavesnes. 
8 cars to an advanced park at Tincourt. 
8 cars to the main park at Peronne. 
The forty lorries were placed : — 

12 at the W.W.C.P. at V.18.C. 
15 at the W.W.C.P. at Longavesnes. 
8 parked as a reserve at Nurlu, and 5 at Hamel. 
The headquarters of No. 3 M.A.C. were at Peronne. 
The Cavalry Corps. — The Cavalry Corps had been reduced 
to three cavalry divisions before the German offensive of 
1918, the Indian units of the 4th and 5th (Indian) Cavalry 
Divisions having been transferred to Egypt. The corps had 
held till 9th March the sector subsequently occupied by the 



GERMAN OFFENSIVE AGAINST FIFTH ARMY 229 

XlXth Corps. Its headquarters were after that date at 
Villers Bretonneux, with advanced headquarters at Villers 
Carbonnel. The corps came under the Third Army on the 
27th March, but returned to the Fifth Army three days later. 
Its divisions were employed in various sectors and moved 
from one corps and one army to another as the situation 
demanded. The A.Ds.M.S. all complained, in these circum- 
stances, of the difficulty of bringing up personnel and equipment 
to the scene of action with the horsed vehicles allotted to 
the cavalry field ambulances. The horses of the ambulance 
wagons became exhausted after bringing up personnel and 
were of little use afterwards for evacuating wounded. There 
is no mention, however, of the motor ambulance transport 
of these cavalry field ambulances. When the cavalry field 
ambulances worked in proximity to field ambulances of divi- 
sions, their tent divisions or main dressing stations were not 
wanted, and the A.Ds.M.S. suggested that the equipment of 
these might well be left behind in order to set free transport 
for personnel. 

The Medical Services of Divisions. 

With regard to the medical services of the divisions com- 
prising the corps of the Fifth Army during the retreat 
details are very incomplete, but from careful reports 
drawn up by the A.Ds.M.S. of five of the divisions 
it would appear that it was only during the first two 
days that it was found difficult or impossible to collect 
all the wounded. The defence scheme defined three lines 
of resistance : a line of thinly held outposts, a main battle 
line of a zone of fortified keeps composed of a chain of mutually 
supported strong points and a trench line behind, about 
3,000 yards from the line of outposts, and a third line of defence 
about 3,000 yards still further back. Advanced dressing 
stations were organized in connexion with each of these lines, 
and the fortified keeps were supplied with dressings, medical 
comforts, stretchers, blankets, splints and orderlies, but not 
with medical officers. Many of these keeps were surrounded 
and captured on the 21st March, and numbers of wounded 
thus fell into the hands of the enemy. The general schemes 
prepared by the divisional A.Ds.M.S. were based on the 
assumption of getting wounded back from the advanced 
dressing stations to the casualty clearing stations as rapidly 
as possible, but their calculations were completely upset by 
the closing of the forward casualty clearing stations, such as 



230 MEDICAL HISTORY OF THE WAR 

those at Cugny and Tincourt, practically before the enemy 
attack was launched, thus necessitating a long journey back 
from advanced dressing stations to the casualty clearing 
stations in back areas. This was the real defect in the 
organization, as there were no echelons of main dressing 
stations prepared for such a contingency. 

After the first two days, however, no difficulties seem to 
have arisen in the Fifth Army divisions, and wounded were 
systematically collected and taken back, one divisional A.D.M.S. 
noting that the rate of retirement was sufficiently slow, namely 
about 1,000 yards in an hour, to admit of this being done. 
The roads were in good condition up to regimental aid posts, 
as the latter were falling back on undamaged areas, and the 
motor ambulance cars were able to go up to them or near 
them ; but the long carry back to casualty clearing stations 
without intermediate main dressing stations, and the resulting 
withdrawal of divisional ambulance transport from the control 
of divisional A.Ds.M.S. and pooling it with the ambulance 
transport of motor ambulance convoys caused immense 
anxiety to many divisional A.Ds.M.S. and field ambulance 
commanders in their efforts to clear the wounded from 
advanced dressing stations before the latter were obliged to 
retire. 

On this point the A.D.M.S. of the 66th Division of the 
XlXth Corps makes the following remarks on the evacuation 
of dressing stations. His advanced dressing stations were, 
at the time of the attack, at Templeux and Jeancourt, and 
withdrew according to plan to successive positions, the distance 
from the original front line to the final line when the corps 
was relieved on the night of the 30th/31st March being 
thirty miles : — 

" All through the whole eleven days, one of the greatest worries and 
anxieties was the difficulty in getting dressing stations evacuated of 
casualties before withdrawing from them. From the beginning to the 
end, there never once was a regular service of ambulances for the purpose 
of evacuation. It was only as the result of repeated appeals to the 
D.D.M.S. and to the M.A.C. direct under instructions from the D.D.M.S. 
that ambulances or lorries were obtained. Sometimes an officer had to 
go to the M.A.C. in person to ensure the arrival of some ambulances at 
the dressing station. 

" It no doubt happened that vehicles, detailed to report to one dressing 
station for evacuation, were utilized by other units. It frequently 
happened that there were two or even three dressing stations, belonging 
to different divisions, in one village. 

" Divisional motor ambulances had to be used to a very considerable 
extent for evacuating to casualty clearing stations. Owing to the fact 
that casualty clearing stations had to be closed very early, the journeys 
to those receiving were very long. In some instances divisional motor 



GERMAN OFFENSIVE AGAINST FIFTH ARMY 231 

ambulances were absent on one journey eighteen hours. This procedure, 
wrong in principle, but necessary under the circumstances, involved the 
risk that it might not have been possible to clear some particular front 
area of casualties, that being the work for which the divisional motor 
ambulances should have been held available. 

" Also the officer responsible for clearing the front area of casualties 
was saddled with a constant anxiety that he might not be able to get 
all his cases away from the dressing station before he had to withdraw 
from it, at a time when all his energies should have been concentrated 
on the work of clearing the area in front. That was often a very real 
anxiety indeed. 

" In spite of the difficulties that had to be overcome, as far as is known, 
every area was cleared of all casualties before the troops withdrew, 
and in every instance the dressing stations were evacuated of all casualties, 
before the field ambulance personnel withdrew to another site. 

" A feature of the work of clearing casualties from the forward area, 
in open warfare, is the extensive use that can be made of motor ambu- 
lances for that purpose. Shelling was not very heavy after the 21st 
March, and roads for the most part were undamaged. Motor ambulances, 
particularly Fords, could be run close up to the front line. The conse- 
quence was that hand carries were much shorter than has ever been 
experienced, even in normal trench warfare. 

" Horsed ambulances also were very useful for conveying sitting cases 
back to the dressing stations. 

" The fact that motor ambulances could be used in this way in the 
forward area made it possible to fix sites well back for dressing stations. 
That was very desirable in view of the instability of the line, enabling 
the personnel at the dressing stations to have longer periods of fixity of 
location." 



< 101 34) 



CHAPTER XIV. 

THE GERMAN OFFENSIVE AGAINST THE THIRD ARMY IN 1918. 

THE withdrawal of the casualty clearing stations of the 
Third Army, immediately after the German attack was 
launched, was more methodical and followed on more clearly 
defined lines than the withdrawal of these units in the Fifth 
Army, but became greatly embarrassed by the interruption 
of traffic on the Albert-Amiens line of railway after the 25th 
March. The loss of equipment and stores was comparatively 
small, and only No. 48 and the Lucknow C.C.Ss. had to be 
sent to the base to refit. The D.M.S. had arranged for nine lorry 
loads of equipment to be ready in each of the more advanced 
casualty clearing stations as a mobile section for immediate 
withdrawal to selected sites further back ; but he had also 
been allotted additional lorries, and was consequently able 
with them to save more equipment than would otherwise 
have been possible. The enemy's rapid advance, however, 
in the southern sectors of the army made it impossible for him 
to retain the casualty clearing stations in his second line and 
they had to fall back almost at once on Edgehill. As had 
been anticipated, Edgehill then became the chief centre at 
which wounded from the southern sectors were concentrated ; 
but by the 26th March the position there was so dangerous 
that it too had to be abandoned, and practically all the sick 
and wounded of the corps engaged were then diverted to 
Doullens and Gezaincourt. The course of events may best 
be followed from the movements of the casualty clearing 
stations. 

The Casualty Clearing Stations. 

Ytres was the most advanced of the casualty clearing 
station sites. No. 48 CCS. remained open there till the last 
moment. The site of this casualty clearing station and its 
vicinity were heavily shelled throughout the 21st March, 
but it remained open, admitting streams of wounded all day 
from 6 a.m. onwards. The situation was reported to the 
D.M.S. at noon, and orders were issued by him to close and 
move to Edgehill. The sisters were sent away that evening. 



MOVEMENT OF CASUALTY CLEARING STATIONS OF THIRD ARMY DURING GERMAN OFFENSIVE, SPRING 1918. 




Scale of miles 

12 3 4- 



5 6 7 8 



4-2 Stationary Hospital 
to Abbeville 26/3. 

AMIENS 



MaJbv&Sons.Lrth 



GERMAN OFFENSIVE AGAINST THIRD ARMY 233 

During the night of the 2 1st /22nd as many of the wounded 
as possible were evacuated by ambulance train, and the 
remainder, 267, were cleared to Edgehill by twenty cars 
sent by orders of the D.M.S. and by nine lorries obtained 
locally. A train of nineteen trucks arrived at 2 a.m. of the 
22nd March, and all but three of the trucks were loaded up 
when the train was obliged to leave at 2 p.m., only a neg- 
ligible quantity of stores being abandoned. It reached 
Edgehill about 6 p.m., where it was unloaded, and No. 48 
CCS. ordered to open at once for walking wounded. 

On the 24th March a party of five medical officers and 
forty other ranks of No. 48 CCS. was ordered to proceed 
to No. 3 (Canadian) Stationary Hospital, Doullens, with 
surgical equipment. They went by train to Amiens, and from 
there marched to Doullens, leaving their equipment at No. 42 
Stationary Hospital at Amiens. They reached Doullens 
during the night of the 26th/27th March. A lorry was then 
sent to Amiens to bring on the equipment. The remainder 
of thi unit was ordered to entrain for Doullens at 11 p.m. 
on the 24th, leaving the equipment behind, with the exception 
of two lorry loads of documents and some other equipment, 
which were to go on by road to Doullens. The train with 
the personnel was held up at Bonnay for several hours in a 
block of trains on the 25th March, and as there seemed little 
prospect of going on, the O.C detrained his personnel and 
marched them to Doullens, where they were employed in 
No. 3 (Canadian) Stationary Hospital. On the 8th April, 
the O.C, Quartermaster and twelve other ranks were sent 
to Boulogne to refit the unit, and the remainder of the 
personnel rejoined them there on the 13th May. The unit 
was then again complete. It was transferred to the IXth 
Corps in the French area and opened at Montigny-sur-Vesle, 
where, at the end of May during the German offensive on the 
Aisne, it had again to abandon its equipment and returned 
to Rouen to refit. 

No. 21 CCS. had been withdrawn from Ytres before the 
attack to a new site at Beaulencourt, where its equipment began 
to arrive at the beginning of March. Most of the personnel, 
however, were attached for duty to No. 48 CCS. The equip- 
ment at the time of the attack had been taken on light railway 
trucks to the new site, but much of it had not been unloaded. 
The personnel attached to No. 48 CCS. rejoined No. 21 
CCS. early on the 22nd March and the unit then received 
orders to move from Beaulencourt to Edgehill. Seven lorries 



234 MEDICAL HISTORY OF THE WAR 

and six ambulance cars arrived to remove unloaded equipment 
about midday, and the O.C. was able to bring away on them 
and on his own two lorries seventy-five patients, X-ray outfit, 
a complete theatre and dressing room outfit, sixty beds and 
mattresses complete, about 350 stretchers, 1,600 blankets, 
medical and surgical panniers, dispensary equipment, two 
large marquees and eight bell tents, thus demonstrating the 
value of having a mobile equipment, which could be carried 
on nine lorries, according to the instructions of the D.G.M.S. 
of September 1916. Edgehill was reached in the evening. 
The unit did not open at Edgehill, but had orders to stand 
by, re-equip from the stores kept by the D.M.S. of the Army 
in a dump at Edgehill and be ready to move. Attempts 
were made to salve the remainder of the equipment left on 
the light railway trucks at Beaulencourt. Fourteen lorries 
were sent off for this purpose on the 24th March, but they 
were stopped by a countermanding order while on their way, 
and the unit ordered to entrain with the equipment of No. 29 
CCS. from Edgehill. For three days it remained on the 
train, being moved from place to place and eventually reaching 
Auxi-le-Chateau on the 26th March. The following day it 
was unloaded in a field on the Abbeville road and proceeded 
to open there with a varied assortment of tentage and equip- 
ment of its own and of No. 29 CCS. It was eventually moved 
to Wavans, on the Auxi-le-Chateau-Doullens road as being 
more convenient for entraining. 

Both of the casualty clearing stations at Achiet-le-Grand 
were open on the 21st March, but were heavily shelled from 
about 5.30 a.m. till noon. Twenty-five of the personnel 
belonging or attached to No. 45 CCS. were killed and eleven 
wounded. The casualty clearing stations were ordered to 
close and move to Aveluy ; the sisters and patients 
being evacuated to Grevillers, as previously arranged. 
Twenty-five lorries had been placed at the disposal of each 
of the two units, and by continuous journeys were able to 
concentrate at Aveluy practically complete by the 23rd March. 

No. 45 CCS. partially opened at Aveluy for walking 
wounded. It had salved everything except tent bottoms and a 
few bell tents in eighty-two lorry loads. Orders were received 
to stand by, and the equipment was stacked at the railway 
siding ready to entrain. The unit entrained on the 24th 
March and left for Doullens about 10 p.m. Its commanding 
officer, Lieut. -Colonel Fitzgerald, proceeded by car to Doullens, 
and was appointed to act as a temporary A. D.M.S. there 
for controlling evacuation by train. 



GERMAN OFFENSIVE AGAINST THIRD ARMY 235 

The journey of No. 45 CCS. to Doullens was eventful. 
At Albert the train was heavily bombed, and at Ribecourt 
it was held up by a block on the line. The personnel was 
detrained at Meaulte and marched from there to Doullens, 
two of the officers and fifty other ranks remaining with the 
equipment on the train. The train arrived at Doullens on 
the 26th March and went on to Gezaincourt to unload. 

The personnel who had marched to Doullens was sent 
to Orville to inspect a site at the XHIth Corps signal school. 
With the exception of officers and other personnel detached 
for duty with No. 3 (Canadian) Stationary Hospital, Doullens, 
the personnel remained in camp at Orville till the end of March. 
On the 1st April the personnel left Orville and took over 
the officers' hospital in the Chateau at Gezaincourt. In the 
meantime, on the 30th March, the equipment and stores, which 
had been detrained complete at Gezaincourt, were handed 
over to other casualty clearing stations that had been with- 
drawn there without their own equipment. On the 7th April 
the unit was moved to Auchy-les-Hesdin, about three miles 
north-east of Hesdin in the Ternoise valley. 

No. 49 CCS. was removed from Achiet-le-Grand in fifty- 
seven lorry loads to Aveluy, where it was under orders not 
to open but to entrain. The train was loaded during the 
night of the 23rd/24th March and left for Puchevillers, which 
it reached at 7 a.m. on the morning of the 24th. Wounded 
commenced to come in large numbers in the evening and by 
midnight about 750 had arrived. Shortly afterwards the 
site was heavily bombed. A long line of cars which had 
brought the wounded was hit ; two of the cars were destroyed 
and others damaged ; three men on them and a R.A.M.C 
orderly were killed. The wounded were evacuated by am- 
bulance trains the following day, but the casualty clearing 
station remained open and admitted many more during the 
25th and night of the 25th/26th March. At 10 a.m. of the 
26th orders were received to close. Ten ambulance cars were 
sent for removing patients to Doullens, and 240 were evacuated 
by them. One hundred walking wounded were marched to 
Doullens, and an ambulance train, which arrived in the evening, 
evacuated the remainder. A truck train was loaded with 
the equipment during the night and left at 8.30 a.m. on the 
27th March, only some of the bulky stores such as bedsteads 
being left behind. During the two days No. 49 CCS. was 
open at Puchevillers it had admitted and cleared 1,550 
wounded. 



236 MEDICAL HISTORY OF THE WAR 

The personnel of No. 49 CCS. left Puchevillers for Auxi-le- 
Chateau by road. The train with the equipment went to 
Doullens and did not reach Auxi-le-Chateau till the 29th 
March. It was then sent on to St. Riquier, where No. 49 
CCS. was finally established. By the 8th April the unit 
was ready to accommodate 500. While it was being opened 
the medical officers were attached to No. 3 (Canadian) 
Stationary Hospital for duty. It was transferred at St. Riquier 
to the Fourth Army on the 22nd April. 

The next casualty clearing stations to move were Nos. 29 
and 3 at Grevillers. No. 29 was ordered to close in the after- 
noon of the 21st March and hand over its site to a field ambul- 
lance. In the early morning of the 22nd nine lorries were 
loaded with stores for a 300-bed unit, and the rest of the 
equipment was placed on an empty ammunition train. The 
personnel of No. 3 CCS. was sent away on this train, being 
relieved by the personnel of No. 29, apparently because the 
former had been worn out by the arduous work of dealing 
with the large numbers of wounded which accumulated at 
Grevillers after No. 29 had closed, as many as 3,627 wounded 
and 300 sick having been admitted to it on the 21st and 22nd 
March. No. 3 CCS. was then cleared of all patients. A 
certain amount of its equipment was left behind and the rest 
loaded on a second train at Grevillers during the night. Both 
trains and the personnel of both units arrived at Edgehill 
early in the morning of the 23rd March, and detrained there. 

Consequent on these moves all the casualty clearing stations 
east of Albert and the Ancre had been withdrawn with com- 
paratively little loss of equipment ; and four of them, Nos. 48, 
21, 3 and 29, were at Edgehill alongside No. 56 on the 25th 
March. Lieut. -Colonel Rae, the O.C of No. 3 CCS., was 
then appointed by the D.M.S. to act as S.M.O. at Edgehill, 
and co-ordinate the work. Wounded were coming to Edgehill 
in large numbers, and Colonel Rae adopted the plan of working 
the personnel of each unit for a few hours at a time in relief 
of one another. 

There appears, however, to have been some confusion at 
Edgehill owing to orders and counter-orders. The group 
of casualty clearing stations was closed down in the morning 
of the 23rd, but No. 48 was reopened. The O.C. of No. 29 
was ordered to entrain his equipment at Edgehill and place 
it in charge of No. 21 CCS. As already noted it left Edgehill 
with the personnel of the latter on the 24th March, but the 
orders to close the group at Edgehill were then countermanded 



GERMAN OFFENSIVE AGAINST THIRD ARMY 237 

and the group reopened. In the afternoon of that day the 
following order was received by Lieut. -Colonel Rae from the 
D.M.S., Third Army :— 

" 56 and 48 C.C.Ss. are to close at once and hand over all cases to 
3 CCS., together with buildings. No more cases will be taken in. 
All will be diverted to Doullens. Two C.C.Ss. will pack up at once. 
3 CCS. will evacuate all cases by A.T. as speedily as possible and then 
pack up." 

There was no mention in the order of Nos. 29 and 21, but 
the D.M.S. clearly intended Edgehill to be closed and no more 
wounded sent there. Its position was becoming dangerous in 
consequence of the enemy's advance into the area between 
the Ancre and the Somme. Some trucks were obtained at 
10 p.m., and as much of the equipment of Nos. 48 and 56 as 
they would hold loaded on to them. The wounded were all 
cleared by ambulance train and temporary ambulance train, 
except a few waiting evacuation by ambulance cars. It was 
Lieut. -Colonel Rae's intention at first to send the personnel of 
all the casualty clearing stations away by the train with the 
equipment, but as no engine had arrived for it by 1 a.m., 
he ordered the personnel of Nos. 3, 29 and 56 to march to 
Doullens, a small detachment of one officer and ten other 
ranks of No. 3 being left behind to look after any wounded 
who might arrive at Edgehill. The personnel of No. 48 had 
already departed on another train, leaving the equipment 
behind, as already noted. 

A train had been sent to Edgehill in the early morning, and 
also twenty lorries, which were to be loaded with the equipment 
left behind at Edgehill. At Warloy, Lieut. -Colonel Rae, with 
the O.C. of No. 56 CCS. and a party of other ranks from 
No. 3 and No. 56, returned to Edgehill in cars of a motor 
ambulance convoy, which had been diverted to Warloy for the 
purpose, in order to salve the equipment. The remainder 
of the personnel of these units and the personnel of No. 29 
reached Doullens on the evening of the 25th March. 

The party from No. 56 CCS. brought thirty- two lorry 
loads of hospital equipment away from Edgehill to Gezaincourt. 
There is no record of the equipment salved by the train, but such 
equipment as had been got away was taken to Gezaincourt, 
where Nos. 3, 29, and 56 C.C.Ss. assembled on the 26th March. 
The equipment and tentage were pooled and the group of 
three casualty clearing stations opened on what had been 
the site of casualty clearing stations during the Somme battles 
of 1916. No. 56 CCS. took over the records and reception 
of the wounded, No. 29 was put in charge of the walking 



238 MEDICAL HISTORY OF THE WAR 

wounded, while No. 3 took over the seriously wounded and 
the officers' hospital in the Chateau. With the stores of 
No. 45 CCS. and such equipment as had been salved from 
Edgehill each unit was more or less fully equipped for 500 
patients and at the end of the month worked as separate units. 

The number of sick and wounded received by this group 
of casualty clearing stations between the 23rd and 30th March 
was 2,101 according to the O.C of No. 56 CCS., who kept the 
records. The number received during the previous two days 
by No. 56 CCS. was 4,205 wounded and 49 sick. 

There were still three casualty clearing stations in the 
southern sector of the Third Army, namely No. 38, No. 4 and 
the Lucknow, all of which had been taken over from the Fifth 
Army with the Vllth Corps. No. 38 had been withdrawn 
from Maricourt Plateau on the 24th March by the D.M.S. of 
the Fifth Army, salving a considerable portion of its stores 
but abandoning half its tent age. Forty lorry loads and 
sixty-six ambulance car loads were brought to La Neuville, 
Corbie, and the unit opened there on the 25th March. It then 
came under the Third Army. On the 26th March the enemy 
was said to be approaching, communication with the D.M.S. 
was cut off, and the railway staff had been withdrawn. The 
patients were evacuated by an ambulance train and also by 
motor ambulance convoy to Amiens ; the stores were aban- 
doned, and the personnel marched to Amiens. Corbie, how- 
ever, although constantly under shell fire, did not fall into the 
hands of the enemy, and during the remaining days of March 
most of the equipment and stores were got away on lorries 
and dumped at Vignacourt. The personnel was sent to Pont 
Remy, and remained there until the unit went on 11th April 
to Fienvillers. 

No. 4 CCS. had been sent from Dozinghem under orders 
from the D.G.M.S. to reinforce the Fifth Army. It arrived 
by train, complete in every respect, on the 26th March at 
Vecquemont, but did not unload. Lieut. -Colon el Rahilly, 
who commanded it, took the precaution of keeping the engine 
with the train, although the engine driver had no coal or 
water. He had been unable to get in communication with 
the D.M.S. of the Third Army, but collected all the coal he 
could in the village and had the train moved down the line. 
It was held up about six miles out, but eventually got away 
to Abbeville, being bombed until it passed Amiens. At 
Abbeville the D.A. & Q.M.G. of the L. of C gave him per- 
mission to take over an Army Musketry School at Pont Remy. 



GERMAN OFFENSIVE AGAINST THIRD ARMY 239 

He arrived there on the 29th March, and opened on 1st April 
with accommodation for 1,000, half in huts and half in marquees. 

The move of the Lucknow C.C.S., which had come to 
Vecquemont from Peronne-la-Chapellette and Maricourt, has 
been described in the account of the moves of casualty clearing 
stations of the Fifth Army. It was withdrawn to Pont Remy 
by the D.M.S., Third Army, and was able to open there with 
such equipment as it had salved. It should be noted, however, 
that a detachment of the unit was with No. 22 CCS. at Bruay, 
in the First Army area, for the reception of sick and wounded 
Indian drivers of ammunition columns. 

After the 26th March, consequently, no casualty clearing 
stations of the Third Army were open south of Doullens 
or east of the Doullens-Amiens road. Doullens and Gezain- 
court were then the centres to which wounded were con- 
centrating. No. 3 (Canadian) Stationary Hospital was crowded 
with them, and was also receiving quantities of surplus 
stores sent back there by medical units. Mobile laboratories 
and personnel of other casualty clearing stations also found 
their way there and were attached for duty. 

The numbers admitted to and discharged day by day 
from this stationary hospital in the Citadel, Doullens, were 
as follows : — 



Date. 


Admitted. 


Discharged. 


March 1918. 

21st 

22nd 

23rd 

24th 

25th 

26th 

27th 

28th 

29th 

30th 

31st 


276 

517 

1,064 

649 

673 

1,622 

1,932 

2,333 

2,228 

1,154 

941 


28 

542 

226 

955 

1,172 

1,411 

1,975 

2,109 

2,433 

1,694 

980 



The hospital was visited by H.M. the King on the 29th 
March, during the heaviest period of work.* 

In April the admissions were not so numerous, although 
on the 5th, 6th and 10th they exceeded 1,000. 

* The King, during His Majesty's visits to the front, visited many other 
medical units at various stages of the war, and in July 1917 Her Majesty the 
Queen made an extended tour of the hospitals on the Lines of Communication 
and at General Headquarters. 



240 MEDICAL HISTORY OF THE WAR 

The evacuation of patients from the casualty clearing 
stations at Gezaincourt and from No. 3 (Canadian) Station- 
ary Hospital was controlled by Lieut. -Colonel Fitzgerald 
of No. 45 CCS. The former were receiving chiefly those 
wounded which were being sent back by the light railway 
from Acheux, and were thus connected more with the opera- 
tions in the northern sector of the Third Army ; the 
latter was receiving casualties that were being cleared 
from the field ambulances of the southern sectors by road. 
Lieut. -Colonel Fitzgerald's chief concern was to relieve the 
congestion at the Citadel. The entraining station at Doullens 
was more than a mile from the Citadel, and a large number 
of ambulance cars was necessary for bringing the wounded 
from the hospital to the trains. Consequently it happened 
that in an emergency some of the cars bringing wounded 
back from the field ambulances were requisitioned by Colonel 
Fitzgerald to assist in this work ; this lead to great delay 
in their return to the field ambulances and consequent diffi- 
culty in getting wounded away from the advanced dressing 
stations before the enemy's advance. At Gezaincourt, on 
the other hand, entraining was easy, as there was an ambulance 
train siding at the site of the casualty clearing stations. It 
was, however, some three miles distant from the Citadel, 
and therefore of less value as an entraining centre for No. 3 
(Canadian) Stationary Hospital. 

The casualty clearing stations in the northern sector of the 
Third Army did not suffer to the same extent as those further 
south. No. 20 CCS. remained at Boisleux-au-Mont while 
No. 43 CCS., which had been withdrawn from that advanced 
position early in March, was being established at Bac du Sud. 
It was, however, being dismantled and tentage was being 
pitched for it at Bac du Sud before the German attack on 
the 21st March. In fact it was practically closed for the 
admission of casualties. All wounded arriving at Boisleux- 
au-Mont were sent on to Bac du Sud. The nursing sisters, 
with the exception of three, had been sent away on the 17th 
March. After the attack the work of dismantling and remov- 
ing the huts of No. 20 CCS. was continued until the 24th 
March, when the unit finally moved to Bac du Sud, having 
salved everything except two Adrian huts, outbuildings and 
a Thresh disinfector. It did not, however, open for work 
at Bac du Sud, but was moved by train to Vignacourt, where 
it commenced to open under canvas on the 28th March. It 
opened there on the 1st April and came under the Fourth 
Army command on the 8th April. ■ 



GERMAN OFFENSIVE AGAINST THIRD ARMY 241 

Consequently all the work of evacuating the wounded from 
the sector immediately south of Arras fell upon No. 43 CCS. 
at Bac du Sud. Seven surgical teams were at work there and 
the tentage and other accommodation of No. 20 CCS. was 
utilized by it. It was not till 4 p.m. of the 21st March that 
wounded began to arrive in a constant stream of about forty 
hourly, a number which had increased to about sixty hourly 
by the 25th March. On that day the advance of the enemy 
placed Bac du Sud in a position of danger, and during the 
night of the 25th/26th March the D.M.S. ordered the sisters 
to be sent away, No. 20 CCS. to pack up and move by rail, 
and No. 43 CCS. to have as much as possible of the equipment 
not in use ready at the railway siding. Twenty trucks had been 
requisitioned for the purpose of removing the equipment by 
rail. The wounded continued to stream in, however, and at 
9 a.m. of the 26th 1,015 were in the unit, 2,455 having been 
evacuated during the previous twenty-four hours. During 
the rest of the day the unit was actively engaged in preparing 
for a move and in sending the wounded away by road and rail. 
All patients were cleared by 5.45 p.m. and by 4.15 a.m. of the 
27th the twenty trucks had been loaded and moved off. Field 
ambulances of the Vlth Corps divisions took over the site 
immediately afterwards. The personnel of No. 43 CCS. was 
sent by lorries to Frevent, where the train with the equipment 
arrived at 7 p.m. No 43 CCS. was then reopened at Frevent 
on the 1st April. The work of the unit at Bac du Sud was 
thus exceptionally severe. Between the 21st and 26th March 
6,134 casualties were admitted. The number of major opera- 
tions performed was 420. 

The remaining group of casualty clearing stations in the Third 
Army were Nos. 7, 8 and 19 at Agnez-les-Duisans. The work 
there was not of an exceptional character and the casualty 
clearing stations were affected by the German offensive to a 
much less extent than the other casualty clearing stations of 
the Army. It was considered advisable, however, to reduce 
the number of units on this site. Nos. 7 and 19 C.C.Ss. were 
closed, the former on the 26th March, and the latter on the 
28th March. No. 7 had only opened for work at Agnez-les- 
Duisans two days before the attack. It had arrived there from 
Bracquemont (Noeux-les-Mines) on the 6th of March. After 
closing at Agnez it was transferred to Ligny St. Flochel, about 
four miles east of St. Pol, near the Arras road, where it detrained 
on the 29th March and opened a few days later on the site of 
the Third Army Trench Mortar School with accommodation 



242 MEDICAL HISTORY OF THE WAR 

for 700 to 1,000 in eighty marquees, some huts, and buildings. 

No. 19 CCS. left Agnez on the 29th March for Frevent, 
where it reopened near No. 43 CCS. on the 15th April. But 
on the 28th March a detachment had been sent to open a 
casualty clearing station for receiving walking wounded at 
Avesnes-le-Comte. This was converted into an advanced 
operating centre on the 2nd April. The detachment remained 
there until the 12th April, when it was withdrawn. 

No. 8 CCS. remained at Agnez-les-Duisans. Its heaviest 
day's work was during the twenty-four hours ending 9 a.m. 
on the 29th March, when 1,545 wounded were admitted from 
the attack along the Scarpe Valley. The unit was transferred 
to the First Army on the 7th April, when the XVI I th Corps 
sector was transferred to that Army. It remained at Agnez 
till the 17th April, when, in consequence of the renewal of the 
German offensive, Agnez-les-Duisans was abandoned and the 
casualty clearing station moved back to Wavrans. 

No. 3 (Canadian) CCS. was transferred from Remy Siding 
to Frevent on the 26th March. It opened near No. 6 Stationary 
Hospital in fields where Nos. 19 and 43 C.C.Ss. were also being 
established after their withdrawal from Bac du Sud and Agnez- 
les-Duisans. 

The successive moves of the Third Army casualty clearing 
stations as described above are shown on the sketch map. 
It will be seen that by the end of March they were all, 
except No. 7, west of, or on, the main railway line from St. 
Pol to Amiens. 

Although most of the casualty clearing stations had lost 
some of their equipment, enough had been salved to enable 
all but one, No. 48, to carry on. No. 48 was sent to Boulogne 
by order of the D.G.M.S. to refit, its personnel being employed 
in No. 3 (Canadian) Stationary Hospital at Doullens till it was 
again ready to go to an Army. Although all the equipment 
of No. 45 CCS. had been salved it had been divided amongst 
the casualty clearing stations at Gezaincourt, and it too was 
sent to Boulogne to be refitted. 

On the 6th April the XVI I th Corps area was taken over 
by the First Army and with it went the casualty clearing 
stations at Agnez-les-Duisans and Ligny St. Flochel. On the 
following day the Fourth Army took over the Vllth Corps 
area, with No. 4 and the Lucknow C.C.Ss. at Pont Remy, and 
No. 20 at Vignacourt. Later on No. 49 at St. Riquier also came 
into the Fourth Army area. 

The headquarters of the Third Army then moved to Hesdin, 



GERMAN OFFENSIVE AGAINST THIRD ARMY 243 

and No. 59 CCS. there was transferred to it from G.H.Q. A 
large amount of surplus stores salved from medical units during 
the retreat had accumulated at Doullens and these were trans- 
ferred to No. 59 CCS. 

The D.M.S. of the Third Army then arranged for No. 45 
CCS. to be placed at Auchy-les-Hesdin in the Ternoise Valley, 
and No. 48, now re-equipped, at Fillievres in the Canche 
Valley, half-way between Hesdin and Frevent. Ligny-sur- 
Canche in the same valley and Wavans in the valley of the 
Authie between Doullens and Auxi-le-Chateau were also sub- 
sequently selected as sites for Third Army casualty clearing 
stations. No. 21 CCS., from Auxi-le-Chateau, was moved 
to Wavans ; No. 3 (Canadian) from Frevent to Ligny-sur- 
Canche. No. 38 CCS., which had been sent to Vignacourt, 
was moved to Fienvillers, on the Doullens-Domart road, when 
Vignacourt came into the Fourth Army area. 

Medical Stores and Laboratories, 
None of the advanced depots of medical stores or mobile 
laboratories of the Third Army lost their equipment. No. 15 
Advanced Depot was at Frevent throughout, No. 16 had 
moved from Boisleux-au-Mont to Bac du Sud before the attack 
and was transferred from there to Auxi-le-Chateau and then 
to Wavans with No. 21 CCS. ; No. 34 was moved from 
Albert, on the 23rd March, to Beauval and thence, in the 
middle of April, to Gezaincourt. Savy, where No. 33 was 
established, came into the First Army area on the 6th April 
and the unit was transferred then to that Army. 

Medical Services of Corps. 

The medical services of the divisions and corps in the Third 
Army during the German attack worked methodically through- 
out, falling back from point to point without confusion and 
according to plan. 

The Vth Corps. — No attack developed on the sector held 
by the Vth Corps on the 21st March, but it was severely 
shelled with gas shells on the Trescault front from the 12th 
to 14th March, as many as 2,131 gassed patients being admitted 
to its medical units during that period. The corps, however, 
had to retire on the 21st March in conformity with the retire- 
ment of the Vllth Corps on its right and the IVth on its left. 
On the 22nd March one of its divisions, the 17th, was heavily 
attacked at Hermies, and although the enemy was repulsed, 
the corps was again obliged to retire in conformity with the 



244 



MEDICAL HISTORY OF THE WAR 



retirement of the corps on its flanks. The casualties admitted 
to the field ambulances were comparatively few as many were 
captured by the enemy in the forward areas. None admitted 
to the field ambulances, however, were abandoned. The 
medical units fell back from day to day until, on the 25th March, 
the dressing stations were all west of the Ancre ; and on the 27th 
March a corps main dressing station was formed at Clairfaye 
near Acheux. All the walking wounded were collected at 
Acheux and sent to Gezaincourt by the light railway. 

The wounded collected by the divisional field ambulances 
of the corps numbered 4,991 between the 21st and 31st March, 
the greatest number on one day being 971 on the 23rd March. 

The IV th Corps. — The IVth Corps advanced dressing stations 
at Doignies, Beetroot factory, and Vaulx were rapidly cut off 
on the attack of 21st March, and many of the wounded of the 
51st Division were captured at Beetroot factory advanced 
dressing station. Wounded came in very slowly, as few could 
be collected owing to the enemy's rapid advance ; but during 
the first twenty-four hours approximately 85 officers and 
1,619 other ranks had been admitted to field ambulances. 
The main dressing stations were at Beugny and Favreuil, and 
to these points the advanced dressing stations withdrew. A 
corps main dressing station and collecting station for walking 
wounded were opened at a place called Loch's Camp about 
one and a half miles from Bapaume on the Bapaume-Cambrai 
road. 

The casualties amongst the R.A.M.C. were heavy : — 





Killed. 


Wounded. 


Missing. 


Total. 




Off. 


O.R. 


Off. 


O.R. 


Off. 


O.R. 


Off. 


O.R. 


6th Division 
25th Division 
51st Division 


1 

2 


3 

] 
? 


1 


4 
2 

? 


1 


25 

? 


2 
3 


7 
28 

* 



* The 51st Division had about 100 other ranks R.A.M.C. 
or captured. 



killed, wounded 



The field ambulances retired day by day on Grevillers and 
thence to the west of the Ancre practically to the positions 
occupied by field ambulances of the VHIth Corps during the 
battles of the Somme in 1916. 

The Vlth Corps. — The Vlth Corps held the sector south of 
Arras. Main dressing stations were open at Ervillers, Hamelin- 
court and Ficheux, with advanced dressing stations at Noreuil 



GERMAN OFFENSIVE AGAINST THIRD ARMY 245 

and Ecoust for the 59th and 34th Divisions, which were the 
two in the line at the time of the attack. A walking wounded 
collecting station was at Mory. The advanced dressing stations 
at Noreuil and Ecoust were captured on the 21st March ; 
on the 22nd March the main dressing station at Ervillers, and 
on the 23rd March the main dressing stations at Ficheux and 
Hamelincourt were withdrawn. Main dressing stations were 
then opened at Blair ville and Ayette. 

During the first forty-eight hours of the battle 70 officers 
and 1,589 other ranks passed through the dressing stations ; 
11 officers and 146 other ranks of the R.A.M.C. were missing 
in the 59th Division alone, and in the 34th Division two 
R.A.M.C. officers and four other ranks were killed, one officer 
and six other ranks wounded, and two officers and twelve other 
ranks missing. 

On the 24th March four divisions, the 40th, 31st, Guards, and 
3rd, were in the Vlth Corps front line. On the 27th March 
a corps main dressing station was formed at Bac du Sud on the 
site of No. 43 C.C.S., with advanced dressing stations at Wailly, 
Blairville, and Monchy-au-Bois. Walking wounded went to a 
field ambulance at Gouy and thence to the detachment of No. 
19 CCS. at Avesnes-le-Comte. The position of the corps 
medical services was then very much the same as those of 
the Vllth Corps during the battle of Arras in 1917. The 
2nd Canadian Division joined the corps on the 30th March and 
the line was then held by it and the Guards and 31st Divisions. 

The XV Ilth Corps.— The XVIIth Corps, which held the 
Scarpe Valley sector, was not attacked till the 28th March. 
As its line was not withdrawn, there was practically no dis- 
turbance of its medical arrangements. The number of wounded 
collected during the twenty-four hours, from 6 a.m. 28th to 
6 a.m. 29th March, was 42 officers and 1,270 other ranks. On 
subsequent days the casualties were comparatively few. 

The Medical Services of Divisions. 

The experiences of the medical services of the divisions in 
the Third Army were similar in many respects to those in the 
Fifth Army. It was difficult in some instances to maintain 
constant communication between field ambulance advanced 
dressing stations and regimental aid posts, chiefly owing to the 
casualties amongst regimental medical officers. Liaison between 
brigades and field ambulances had in such instances been de- 
fective, especially in keeping the A.D.M.S. informed of the 
casualties amongst battalion medical officers. 



246 MEDICAL HISTORY OF THE WAR 

But the chief difficulties were in clearing the wounded 
back from the advanced dressing stations. The heavy shelling 
of the roads, and the exceptional congestion of traffic on them 
made the task extremely arduous. Ambulance cars were 
held up with wounded in them for long periods, and, further, 
many of the motor ambulance convoy cars were unable to 
assist in evacuating the field ambulances, as they had to be 
employed in clearing the casualty clearing stations when it 
was impossible to clear them by ambulance trains. Conse- 
quently, although reserve convoys under the D.G.M.S. and 
D.M.S., L. of C. control were sent up to help in clearing the 
casualty clearing stations, the field ambulance cars had 
frequently to help the corps convoys in clearing the main 
dressing stations to Edgehill and Doullens, and were often 
away for many hours. For instance, as mentioned above, the 
ambulance cars of one field ambulance were held up at 
Doullens to assist in moving patients from No. 3 (Canadian) 
Stationary Hospital to the entraining station. In other cases 
field ambulance cars on arriving at the casualty clearing 
station site found it abandoned and had to continue the 
journey to Doullens ; or on their way back to their unit they 
might be stopped to pick up seriously wounded and go back 
with them to a casualty clearing station. 

The result of this was that severely wounded collected in 
advanced dressing stations could not be got away before the 
enemy captured the position ; but all wounded admitted to 
a main dressing station were saved from capture. 

A.Ds.M.S. of divisions and Os.C. of field ambulances strongly 
emphasize the importance of establishing main dressing stations 
of divisions or corps at fixed points during a retreat ; and on 
field ambulances retaining their own ambulance transport 
solely for bringing wounded back from the front area and 
advanced dressing stations to these main dressing stations 
and no further. Had this been done probably all the wounded 
collected would have got back. 

Medical Arrangements for French Sick and Wounded. 

French troops were operating in April in the areas of the 
Fourth and Third Armies and arrangements were then made 
by the D. D.G.M.S. in consultation with the D.M.S. of the 
French Xth Army, Med. Inspecteur General Simonin, for 
French sick and wounded to be received into the casualty clear- 
ing stations of the Third and Fourth Armies and cleared from 
there either by a French ambulance train being brought up, 



GERMAN OFFENSIVE AGAINST THIRD ARMY 247 






o 

si 

Sffl 

o <u 


* 


— -*©©CNt/5I^©— CN-<* 
NOaiflOO)H •* © 00 © 

■* t>^ -* ©_ ■* cn_ — © oo_ cn_ © 
cn" cn" ©" ©" ->*" qo" ■>*" co eo cn" ©~ 


t^ Tf o r* co — ,co 

00 CD © © lO © © 

00 — ** CD CN © 1 CO 

— CN©" 


© 
© 

© 


if 

H<3 


cNr^- — ©oo©cn©->*© 
-©-*©© — ©^©1/5© 
•* c» co © — f>._ ©_ cn r* ao •^ 
CN ©" -*"«" CD CN ■*" CO* ©" CN r-T 


CD COCO©© 1/5 CO 

©©oo-* — t^ •** 
©_© ^o ©_©_ 1 ©_ 
cn" — — cn"'* — 


oo 
© 
© 


in 
1 

tn 

1 

nj 

V 

O 

3 
58 
O 
o 
n 
§ 
1 

1 
< 


1 

< 


■ en 


221 1 1 HI I I 1 


1 1 1 1 1 l-l 


© 


IS 
o 
H 


0,782 
5,706 

rtain 


co©cocn © 

©©©©!« 

CO 00 CN CN — 


© 


tri 


5,484 
5,490 

unce 


co in — ©cd 

CN CO 1/5 CO f 
CN 00 CN CN — 


CN 

© 


o 


. >. 


© 
© 

© 


ss'r 1 1 1 1-1 1 1 i 

CNCN 


1 I 1 ©TfCNCNCD 

1 1 1 ooco — — 


< 

.fcl 


i t/i 


I CO I 1 CO 1 t^CN© 00 — 


© I©'*-*-*— 1 


CN 


*c3 
o 
H 


oooo — ■* r» oo co — r» o 

©■«* (DO-<OOMS^ 

»h ©_ 1 ct^-^o^cd^co ■* — cn_ 
— " — "©"cn"cn"co"cn" — — 


— cn© coin © © cn 

CN00r~NCNCN©COU5 

«/5 m u5 © ^oo_© '* 

CNCN 


co 
cd" 

CN 


d 


r% © co •«* © r* — cd © co 

OO) |©©©t^ — ©©© 

— cn 1 oo cnoo -* CO «© -^ 

— — "cn"cn"cn"©"cn"— "— " 


©u5©t^inco- •«* 
©©•*l>OCD© — CN 

CNCN 


© 
CN 

oo" 

CN 


tri 

o 


— co © o <N — © © cn t>. 
irt 1 co r^ cd co cr> o o •* 


oor^t^©©©i/5X 

CN — CN — ©©CNCN 


© 
© 
CN 


a 
— 
.a 

1 

2 
"33 

o 

i 

o 

1 

< 


I 

.a 


oj a 


*l 1 1 1 1 1 1 1 1 1 


11111--! 


■* 


73 


o 

CD 

1/5 "1 


r^© t^ •* © 

1/5 CN 1/5 — © 
— © — CN — 
CN 


IN 

oo" 


(2 
d 


8 1 

© H 


MOMOt 
© CD •* © CN 
©_i/5 — CN- 
CN 


© 
© 
oo" 


d 

o 




© 


S'l ll 1 1 1 1 1 1 1 


1 1 1 28°.°^ 


9 

< 

.1 

H 




1 CN I 1 IN 1 (DOMflO) 
1 — 1 1 1 — CN © — 


"*© — mm — | 1 
— >* ©m 1 1 


© 

© 

CN 




com T cn t^ re cd cn cn o 

t^ 00 1 00 CN rf © CD X CT> © 
CN — 1 ©__©^©_— [>.__— _©© 
CN — — — CN©" — 


©©oo — ©©©oo 

1/5 — r~©CO©CDCN 

"* <o © © — ©_-* — 
©"— " — 


a 

©_ 

CN 


in 

d 


274 
2,105 

1,514 
1,577 
1,586 
2,079 
3,611 
1,116 
852 
619 


"00)050U5tN(N 

©©Tf>rf©00©X 

'*"*©©©CN'T© 

©"— — " 


© 
© 
© 
©" 
CN 

CN 

© 
©_ 


o 


(NO ©i/5 — © © © t>. — 

oo r-« -* co oo © co -<* co 


CN©©CN©i/5©© 
CNCNCN— ©t>.CN'* 




s 

Q 




0O0OO0O00OO00OGOX0O0O 


0000000000000000 


— 

"73 


cococococococococococo 
— cN©-<i*©©°r>>o6c7io — 

CNCNCNCNCNCNCNCNCN©© 


— CN CO -*' irt" ©' t> 00 



10134 



248 MEDICAL HISTORY OF THE WAR 

to the British CCS. should the number of French patients 
justify this, or by French ambulance cars bringing them 
to a French hospital or to the entraining station of French 
ambulance trains. The French became responsible for thus 
clearing their casualties from the British casualty clearing 
stations, but if they were unable to bring up trains or 
cars it was arranged to evacuate French sick and wounded 
along with the British casualties to the British bases where 
there were also French hospitals, and to have them transferred 
to these hospitals direct from the ambulance trains. These 
arrangements worked smoothly in the Third and Fourth Army 
areas. 

Casualties during the German Offensive on the Somme. 

The records of the number of casualties admitted to field 
ambulances and casualty clearing stations of the Third Army 
are fairly complete ; but the Fifth Army units were unable 
to maintain their records or had to abandon them. Such 
records as are obtainable from the diaries of the medical 
units from the 21st March to 8th April are shown in the table 
on the preceding page. 



CHAPTER XV. 

THE GERMAN OFFENSIVE ON THE LYS IN 1918. 

THE enemy's offensive against Amiens and Arras had 
scarcely been brought to a standstill before he launched 
a second attack, this time against the First and Second Army 
front from the Bethune-La Bassee Canal to the Ypres salient. 
The offensive commenced with a heavy bombardment 
along the front from Lens to Armentieres, more especially of 
gas shells on the right and left of the British positions, and on 
the 9th April a strong attack was made on the sector held by 
the 2nd Portuguese Division in the Neuve Chapelle-Laventie 
area. The Portuguese had the 55th (British) Division of the 
1st Corps on their right on the La Bassee front and the 40th 
(British) Division of the XI th Corps on their left on the Bois 
Grenier front. The 51st and 50th Divisions were behind in 
support. The Portuguese Division was overwhelmed, and 
the gap made by its retirement was held for a time near Vieille 
Chapelle by 1st King Edward's Horse and the 11th Cyclist 
Battalion until the 51st and 50th Divisions came into action. 
The 40th Division was forced to retire across the Lys, while 
the 55th held its ground at Festubert. A line was then held 
on the night of 9th April east of the canalized River Lawe 
between the La Bassee Canal, north of Bethune, and the 
Lys Canal at Estaires. The attack was renewed on the 10th 
April and the enemy pressed back the British line by the even- 
ing to the west of the Lawe at Vieille Chapelle, through Lestrem 
to between Estaires and Merville, and along the Armentieres- 
Bailleul railway to the north of Steenwerck. The attack 
was also pushed against the 25th and 19th Divisions of the 
Second Army and the line held by them was driven back 
to Ploegsteert, Messines and Wytschaete. The 9th Division 
on the left, however, cleared the position and the Messines 
ridge was held. In the meantime the 34tb Division in 
Armentieres, being thus exposed on both flanks, though not 
attacked except by previous gas shelling, was withdrawn 
to the left bank of the Lys. 

(10134) i » 



250 MEDICAL HISTORY OF THE WAR 

On the 11th April the pressure of the enemy continued 
and Merville was captured. Much fighting took place on the 
Messines ridge, and the troops which were holding the Ploeg- 
steert sector were obliged to fall back to positions east of 
Neuve Eglise and Wulverghem, leaving Hill 63 and Messines 
positions in the hands of the enemy. Reinforcements were 
now being brought up from the southern sectors of the First 
Army and the neighbourhood of Arras. 

There was still desperate fighting on the 12th April in the 
area between Merville and Bethune and in the area between 
Merville and Bailleul to the east of the Forest of Nieppe. In 
the former area the enemy broke through the British line 
and formed a salient between Hinges and St. Venant, reaching 
its farthest point half-way between Mt.Bernenchori and Robecq. 
In the latter area the line was forced back to the immediate 
south of Bailleul and to between Oultersteene and Merris, 
but the enemy advance towards Hazebrouck was definitely 
checked between Meteren and the Forest of Nieppe. 

Fighting continued north of this line on the following days 
around Neuve Eglise and Wytschaete, and on the 15th April 
Bailleul came into the enemy's possession. The British 
line was then straightened from Meteren to Dranoutre, and 
shortened in the Ypres salient by gradual withdrawal from 
the Passchendaele ridge. French forces forming a detachment 
of the Armee du Nord were moved in support of the British. 
On the 17th April attacks were made on Kemmel Hill and 
along the whole front from Givenchy to west of Merville, 
but were repulsed. French troops then gradually relieved 
the British and by the 21st April held the whole of the front 
from St. Jans Cappel to Kemmel Hill with four divisions. 

Fighting then died down till the 25th April when a strong 
attack was made on the French and British line from Bailleul 
to the Ypres-Comines Canal. The 9th Division with part 
of the 49th and 21st Divisions were on the French left in the 
neighbourhood of Wytschaete and the 1st Australian on the 
French right south-west of Bailleul. The main attack was on 
the Kemmel Hill and on the 9th Division positions. Kemmel 
Hill was captured from the French, but after counter-attacks 
by the 9th, 21st, 25th, 49th, 30th and 39th Divisions in con- 
junction with the French the line remained otherwise unbroken. 
Owing to the occupation of Kemmel Hill by the enemy, 
however, the line of the Ypres salient was withdrawn to east 
of Pilckem and St. Jean, and thence to Zillebeke Lake and 
the west of Voormezeele. 



M OVE M E NT OF CASUALTY CLEARING STATIONS 



OF FIRST & SEC OND ARMIES DURING THE GERMAN OFFENSIVE ON THE LYS,I9I8 

Berques 




GERMAN OFFENSIVE ON THE LYS, 1918 251 

With another determined attack on the 29th April, which 
was repulsed, the German offensive of 1918 on the British 
front ended. 

In the meantime the 8th, 21st, 50th and 25th Divisions 
were being transferred under the IXth Corps command 
to replace French divisions of the Sixth French Army 
that were sent to support the British behind Amiens. The 8th, 
21st and 50th Divisions were put into the line north-west of 
Rheims, and, with the 25th Division, were involved in a 
great German attack along the whole of the Aisne front to 
Rheims on the 27th May. The allied line was broken and the 
enemy reached the Marne, where on the 6th June his advance 
was checked. 

On the following day " a fresh battle broke out on the French 
front between Noyon and Montdidier,"* but without serious 
effect on the allied line. It was then, however, necessary to 
withdraw the French divisions from the British area in Flanders 
to the French front south of the Somme, and four more British 
divisions were placed at the disposal of Marshal Foch behind 
the junction of the French and British in front of Amiens. 
The XXIInd Corps with the 51st, 62nd, 15th and 34th Divisions 
was accordingly sent to positions behind the junction of 
the French and British on the Amiens front. The result of 
these operations on the British medical services is described 
later on. 

The Medical Situation at the time of the Offensive. 

With regard to the medical services during the offensive 
on the Lys, the events on the Somme had given early warning 
of the disadvantages and risks of retaining casualty clearing 
stations in forward positions. 

The experience of the ten days of the German offensive 
against the Fifth and Third Armies had also shown how im- 
portant it was for medical units to retain their mobility and 
to be guided by the principles laid down in the Manual of 
R.A.M.C. Training. This was impressed on the medical 
services by the D.G.M.S. in the following memorandum issued 
on the 2nd April to Ds.M.S. of Armies : — 

" The experience of the last ten days of March demonstrates the para- 
mount importance of medical units maintaining their mobility in the field. 

" Trench warfare and the desire to carry on surgical work to the highest 
degree of perfection have led casualty clearing stations to become large and 
immobile units, pushed as far forward as possible, thus diminishing the 
tactical importance of maintaining mobile main dressing stations at inter- 
mediate positions. 

* Sir Douglas Haig's despatches, p. 254. 



252 MEDICAL HISTORY OF THE WAR 

" The consequence of this has been that in certain areas casualty clearing 
stations have had to abandon valuable equipment in retiring, that in some 
instances no main dressing stations had been opened in their place for the 
reception of wounded, and that the motor ambulance cars of the field ambu- 
lances have been employed in carrying the wounded back to casualty clearing 
stations to the new positions of the latter farther back. 

" In consequence of the time lost in returning from these, the field ambulance 
cars have not been able to arrive in time to remove lying-down cases collected 
at the collecting posts by the bearer divisions, and many wounded unable to 
walk have been abandoned. 

" Much of this might have been avoided if the principle had been invariably 
adhered to of working the motor ambulance transport of field ambulances 
in collecting wounded from collecting posts to main dressing stations and no 
farther. 

" Your attention, therefore, is directed to the importance of arranging that 
when casualty clearing stations are situated far back from the front line, as 
they ought to be in the present military situation, intermediate main dressing 
station positions, which can be moved rapidly in echelon backwards or for- 
wards as required, shall be established by divisions or corps, and that the 
motor ambulance transport of the field ambulances in the front area shall 
be employed for bringing wounded back only to these main dressing station 
points. 

" The motor ambulance convoys are intended for the purpose of working 
between main dressing stations and the casualty clearing stations and should 
be employed for that purpose and not for general work in a pool with the 
motor ambulance transport of the field ambulances. 

" Should our front line in the course of pressure by the enemy be forced 
back, the withdrawal of the main dressing stations will necessarily be in accord- 
ance with the general situation, but they should be established at suitable 
points in echelon during the withdrawal, so that there shall always be a point 
to which the motor ambulance transport of the field ambulances can bring 
their wounded without having to go farther back, and to which the motor 
ambulance convoys can work without having to go farther forward." 

In other respects the Director-General's arrangements 
issued on 6th March held good. Motor ambulance cars and 
surgical teams were diverted from the Third and Fifth to the 
First and Second Armies, when the position of the former had 
become stable and resources which had been at the disposal 
of the D.G.M.S. during the Somme offensive were available 
for the offensive on the Lys. 

After the battle of Vimy Ridge in 1917 the D.M.S. of the First 
Army had moved his casualty clearing stations to positions 
much nearer the front line than had previously been considered 
advisable. In September and October 1917 he had transferred 
No. 30 from Aubigny and No. 57 from Aire to Anzin-St. Aubin, 
in the Scarpe Valley, about three miles north-west of Arras 
and about nine from the front line. In November and Decem- 
ber he had established a group of three casualty clearing 
stations, No. 6, No. 1 (Canadian) and No. 4 (Canadian), under 
canvas and in huts in open ground near Ruitz, about seven 
miles from the front line ; while another casualty clearing 
station, No. 7, was still farther forward at Bracquemont, 



GERMAN OFFENSIVE ON THE LYS, 1918 253 

Noeux-les-Mines, only slightly more than four miles from 
the front line. No. 33 C.C.S. at Bethune, and Nos. 51 and 54 
at Merville were also within the danger zone, at distances of 
five and seven miles respectively from the front line. No. 1 
at Chocques was also within ten miles of the front line. With 
the exception of Bethune, Noeux-les-Mines and St. Aubin, 
which were frequently exposed to long range high explosive 
shells, these units had been fairly free from hostile action. 
But the positions were recognized to be unsuitable for a policy 
of defence. No. 7 C.C.S. was consequently transferred from 
Bracquemont on the 6th March to Agnez-les-Duisans, as 
noted in the previous chapter ; and before the German offensive 
of the 21st March had taken place, No. 57 was being moved 
to Aubigny from St. Aubin. No. 33 had been moved from 
Bethune towards the end of February to a site near Havers- 
kerque ; so that the units remaining at Ruitz, St. Aubin, 
Chocques and Merville only were within the danger zone on 
the 21st March. 

On the 23rd March, in consequence of the events in the 
Fifth and Third Armies, the D.G.M.S. instructed the D.M.S., 
First Army, to move back his casualty clearing stations from 
these places with the least possible delay to positions which 
would enable evacuation by ambulance train to be carried 
out from the railway line running through Lapugnoy, Pernes 
and St. Pol. If the D.M.S., First Army, considered it essential 
to retain within the more forward zone means of dealing 
with urgent surgical cases, he was instructed to form an ad- 
vanced operating centre with personnel and material capable 
of being moved by the lorries belonging to the casualty 
clearing stations. In fact, all casualty clearing stations had 
been warned by the D.G.M.S. as early as the 3rd March 
to be in possession of their mobilization equipment of marquees 
in the event of their being required to move at short notice. 
Many of these marquees had been distributed to field ambulances 
for various purposes, especially those of casualty clearing 
stations which had been accommodated in buildings and huts. 

Consequent on these instructions, the D.M.S. of the First 
Army immediately moved No. 30 from St. Aubin to Wavrans 
on the St. Pol-Anvin railway line, No. 54 from Merville to 
Haverskerque alongside No. 33, and No. 4 Canadian from 
Ruitz to Pernes on the St. Pol-Lapugnoy line. These moves 
had been completed before the attack of the 9th April. No. 18 
was also moved as a precautionary measure from Lapugnoy 
to Lillers at the beginning of April. The section of the Lucknow 



254 



MEDICAL HISTORY OF THE WAR 



CCS. attached to No. 22 at Bruay for Indian drivers was 
not, however, moved back at that time. 

The situation of casualty clearing stations of the First 
Army on the 9th April was consequently as follows : — 



Casualty Clearing Station. 


Locality. 


Distance 
from Front. 




Forward Areas — 






No. 1 


Chocques 




8 miles. 


No. 6 


Ruitz 




7 miles. 


No. 22 


Bruay 


} 


9 „ 


Lucknow (detachment) 


>} 


No. 51 


Merville 
Intermediate Areas — 




7 „ 


No. 23 


Lozinghem 




11 „ 


No. 42 




Aubigny 


"I 


11 „ 


No. 57 






j 


No. 58 




Lillers 


) 


12 „ 


No. 18 






j 


No. 33 




Haverskerque 


\ 


11 „ 


No. 54 




„ 


J 




Back Areas — 






No. 30 


Wavrans 




18 „ 


No. 4 (Canadian) 


Pernes 


} 


15 „ 


No. 1 (Canadian) 


,, 


No. 7 


Ligny St. Flochel. . 




18 „ 



There was also a Portuguese CCS. at St. Venant, and 
No. 8 CCS. at Agnez-les-Duisans was practically taken 
over by the First Army, although not actually transferred 
for some days later. 

The casualty clearing stations of the Second Army were 
also being moved from forward positions. The most advanced 
of the casualty clearing stations was No. 2 (Australian) at Trois 
Arbres, within four or five miles of the front line. It was 
moved to Oultersteene on 15th March. It then formed 
one of a group of casualty clearing stations there with 
No. 2 and No. 1 (Australian), but these casualty clearing 
stations, and No. 53 at Bailleul, Nos. 4 and 47 at Dozinghem, 
were also in a dangerously forward area of six to eight miles 
from the front line. The Bailleul and Dozinghem positions 
were abandoned by the transfer of No. 47 CCS. to the Fifth 
Army on the 7th March, No. 53 on the 8th March, and No. 4 
on the 25th March. The casualty clearing station group at 
Oultersteene was then transferred during the first week in April 
to a siding on the railway line north-west of Hazebrouck 



GERMAN OFFENSIVE ON THE LYS, 1918 255 



called " Ana Jana Siding," one of the group, No. 2, being sent 
still farther back to Ebblinghem, between Hazebrouck and 
Arques, where No. 15 had already been established after 
the battles of Ypres in 1917. 

There were, however, other groups of casualty clearing 
stations within the danger zone when the offensive of 9th 
April was launched, and the D.M.S. of the Second Army had 
been taking steps to reduce the number of casualty 
clearing stations in the forward areas. No. 3 (Canadian) 
CCS. had been transferred from Remy Siding to the Third 
Army on the 25th March, and No. 17 to Ana Jana Siding 
on the 2nd April, leaving only No. 10 and No. 2 (Canadian) 
CCS. at Remy Siding. No. 12 CCS. was transferred from 
Mendinghem to the Fifth Army on 30th March, and only 
No. 64 remained at that place. No. 44 CCS. was moved 
from Nine Elms to Arneke on the 5th April, No. 3 (Australian) 
only remaining at Nine Elms. Of the two at Bandaghem, 
No. 63 CCS. was transferred to Arneke on the 3rd April, 
leaving No. 62 CCS. there. 

The position of casualty clearing stations in the Second 
Army in anticipation of the offensive was consequently 
as follows : — 



Casualty Clearing Station. 


Locality. 


Approx. 

Distance 

from Front. 




Forward Area — ■ 




No. 10 

No. 2 (Canadian) 

No. 11 


Remy Siding 
Godewaersvelde . . 


> 8 miles. 
9 „ 


No. 64 


Mendinghem 


8 „ 


No. 36 

No. 3 (Australian) 

No. 62 


Roosbiugge 
Nine Elms 
Bandaghem 

Back Area — 


9 „ 

8 „ 

9 „ 


No. 13 


Arneke 


^j 


No. 44 


„ 


V20 „ 


No. 63 


„ 


J 


No. 15 

No. 2 


Ebblinghem 


\ 19 „ 


No. 17 


Ana Jana . . 


] 


No. 1 (Australian) 
No. 2 





> 15 „ 



The Medical Services of the First Army during the Offensive. 

The Casualty Clearing Stations. — Immediately after the 

German attack on the 9th April, the casualty clearing 



256 MEDICAL HISTORY OF THE WAR 

stations of the First Army at Ruitz, Bruay, Chocques, Lillers, 
Merville and Haverskerque were in danger ; No. 6 CCS. 
was withdrawn from Ruitz to Pernes ; No. 22 from Bruay to 
Lozinghem ; No. 51 from Merville and Nos. 33 and 54 from 
Haverskerque to Aire by the 12th April. The two casualty 
clearing stations at Lillers, No. 18, which had just come there, 
and No. 58, were rapidly withdrawn, the former to Arques 
and later on to Malassise, and the latter to Longuenesse in 
the St. Omer area. No. 1 was withdrawn from Chocques to 
Arques on the 10th April. These three casualty clearing 
stations remained, however, parked for the time being pending 
a decision regarding the move of Lines of Communication 
medical units from St. Omer and Arques. 

The Portuguese casualty clearing stations at Merville and 
St. Venant, owing to the attack on the Portuguese front and 
the reorganization of the Portuguese divisions, were with- 
drawn and arrangements had to be made by the D.M.S. of 
the First Army for their wounded being taken over by British 
medical units. 

The situation, therefore, in the First Army during the first 
week of the German offensive on the Lys was that all of its 
casualty clearing stations, except Nos. 22 and 23, which were 
at Lozinghem, Nos. 42 and 57 at Aubigny, and No. 8 and No. 7, 
which were at the disposal of the First Army, or had been 
taken over by it from the Third Army at Agnez-les-Duisans 
and Ligny St. Flochel, were back in the neighbourhood of St. 
Omer, Aire, Pernes and Wavrans. No. 8, however, was moved 
from Agnez-les-Duisans to Wavrans on the 17th April. 

The D.M.S. of the First Army had been under the impression 
that his casualty clearing stations could be established at 
St. Omer, but, when it was decided that St. Omer should come 
into the Second Army area, he withdrew No. 1 from Arques 
to Elnes the nearest point to St. Omer in the First Army area. 
No. 18 at Arques and No. 58 at Longuenesse were then trans- 
ferred to the Second Army. Subsequently, at the beginning 
of July, Elnes passed into the Fifth Army area. No. 8 CCS. 
and No. 1 CCS. then took one another's place at Elnes and 
Wavrans respectively, owing to the desire of the First Army 
D.M.S. to retain No. 1 CCS. in his area. 

This situation of the casualty clearing stations remained 
unchanged in the First Army during April, the casualties 
being evacuated to the casualty clearing stations in these 
localities through main dressing stations of corps and divisions. 
Neither personnel nor much of the equipment of casualty 



GERMAN OFFENSIVE ON THE LYS, 1918 257 

clearing stations had been lost owing to the early steps taken 
to withdraw them from forward positions. But the two 
casualty clearing stations at Lozinghem, Nos. 22 and 23, 
remained within six or seven miles of the farthest point to 
which the Germans advanced in the direction of Lillers. 
Lozinghem was then exposed to artillery fire and both the 
casualty clearing stations there were shelled on the 9th May. 
They were then withdrawn to Pernes and Anvin respectively. 

Until the end of the German offensive and the commencement 
of the allied advance, the First Army evacuation centres were 
thus concentrated at Aire, Pernes, Wavrans, Anvin, Aubigny 
and Ligny St. Flochel, to which No. 33 was moved from 
Aire on the 9th May. In addition, the First Army had two 
stationary hospitals, No. 39 at Fort Gassion, Aire, and No. 12 
at St. Pol. 

The situation of casualty clearing stations of the First 
Army was therefore as follows at the end of the German 
offensive : — 

Aubigny . . . . . . Nos. 42 and 47. 

Wavrans . . . . . . Nos. 30 and 1 (replaced at Elnes by No. 8). 

Pernes . . . . . . No. 4 (Canadian), 1 (Canadian), No. 6 and 

No. 22. 

Ligny St. Flochel . . . . Nos. 7 and 33 (from Aire). 

Aire . . . . . . . . Nos. 51 and 54. 

Anvin Nos. 23, 2 and 15 (the two latter C.C.Ss, 

had been transferred from the Second 
Army at the end of June). 

Most of the new sites selected, such as those at Wavrans, 
Pernes and Anvin, were at some distance from the railway 
line, owing to the frequent shelling of and air raids on railway 
stations and junctions. 

The D.M.S. of the First Army had delegated a part of the 
administration of his casualty clearing stations to the D.Ds.M.S. 
of Corps in whose area they were situated, as by so doing he 
considered that the casualty clearing stations would have 
more ready assistance from the corps staff in connexion 
with engineer services and with the control of wastage. This 
delegation of control or modified administration was not 
favoured by the D.G.M.S. at G.H.Q. and was not officially 
recognized, the main objections being that the control of 
the casualty clearing stations became a dual control, being 
partly by the D.M.S. of the Army and partly by the D.D.M.S. 
of the corps, and that as the corps areas were constantly 
changing, the O.Cs. of casualty clearing stations would con- 
sequently be subjected to frequent changes in administrative 



258 MEDICAL HISTORY OF THE WAR 

control. Further, the work of casualty clearing stations was 
not corps work. They received casualties from more than 
one corps, so that the regulation of the admission to any 
one casualty clearing station could not be vested in the D.D.M.S. 
of any one corps but only in the D.M.S. of the Army. The 
casualty clearing stations were essentially the links between 
armies and the lines of communication, and it was therefore 
extremely undesirable that their administration should pass 
out of the hands of the Army Headquarters administration 
into that of a tactical formation such as a corps. It was 
not surprising, therefore, that this system of delegation of 
control led to difficulties when the battle commenced and 
the withdrawal of casualty clearing stations from their old 
positions to positions farther back became necessary. In 
fact, the diaries of the D.Ds.M.S. of corps in the First Army 
during and after the offensive are filled to a great extent 
with details of transfers of casualty clearing stations from 
one corps to another and with discussions regarding the ad- 
ministration of a casualty clearing station receiving only 
the sick and wounded of one corps and in selecting sites 
and other details for the establishment of casualty clearing 
stations, matters which should properly have been settled 
by the D.M.S. of the Army. 

The Outbreak of Influenza. — During May and June influenza 
of a mild type had been more or less prevalent in the First 
Army, extensive outbreaks constantly occurring in various 
units and manifestly of a very infectious character. It became 
so marked that the D.M.S. of the Army issued a special 
instruction on the subject on the 20th June, the chief object 
of which was to retain the patients under treatment in the 
army area and thus avoid their evacuation to the base. It 
was not then considered to be of a serious nature, and the 
patients returned to duty after a week or ten days. However, 
on the 21st June, 3,000 beds at Etaples were placed at the 
disposal of the First Army for these cases by the D.G.M.S. 
The patients were to be sent there by special ambulance 
trains, labelled " First Army P.U.O.* Special, Etaples." On 
recovery they were to be returned direct to the First Army. 
The first of these special trains left on the 22nd June from 
Pernes, Aubigny, Ligny and Aire ; but difficulties at once 
arose at the base because at the general hospitals there were no 
pack stores for kits and equipment which accompanied the 

* P.U.O. = "Pyrexia of uncertain origin." 



GERMAN OFFENSIVE ON THE LYS, 1918 259 

men in order to facilitate their return. The general hospitals 
had not been organized to function as casualty clearing 
stations or corps rest stations of armies, and this interference 
with their functions was not advantageous, more especially 
as the 3,000 beds were filled up in three days by these special 
cases from the First Army, and were of no further use. 

At the end of the active period of operations in June the 
high rate of sickness from influenza materially affected the 
situation, an attack, for example, which had been organized 
by the 29th Division against La Becque on the 20th June, 
having to be postponed on account of this. 

The Medical Services of Corps. — The corps of the First 
Army on the 9th April from right to left were the XVI I th, 
XHIth, Canadian, 1st, Xlth and XVth. The Cavalry Corps 
was moved into the First Army area just after the attack 
was launched. The 1st, Xlth and XVth were the corps chiefly 
concerned in the defence against the enemy attack, more 
especially the two last. 

The 1st Corps held the line south of the La Bassee Canal 
to Lens, with the 46th and 11th Divisions, and with the 3rd 
and 51st Divisions in reserve, but the number and positions of 
divisions changed, and on the 14th April the 1st Corps had 
four divisions in the line, the 11th, 1st, 3rd and 4th, with the 
55th in corps reserve and the 46th Division in Army reserve. 
The 55th Division had been transferred from the Xlth Corps 
on the 12th April after it had held the enemy back at Festubert. 
The 46th Division front was taken over on the 11th April 
by the 3rd Canadian Division and went into Army reserve. 

As the casualty clearing stations withdrew from the forward 
positions main dressing stations of field ambulances took 
their place. The main dressing station of the 11th Division, 
for example, occupied the site of the casualty clearing stations 
at Ruitz, where, however, on the 17th April' difncul ties arose 
in consequence of two battalions marching to the site and 
camping there. The D.D.M.S. at once objected to this and 
the battalions were moved to another site. 

On the 24th April the XHIth Corps took over the left 
sector of the 1st Corps front along the La Bassee Canal line 
from Bethune to Robecq and held it with the 3rd and 4th 
Divisions. The 1st Corps front was then held by the 11th 
Division on the right sector, the 1st Division in the Cambrin 
sector, with the 55th Division along a sector from Givenchy 
to Festubert, and the 46th Division from Festubert to the 
Lawe river. 

10134 U 



260 MEDICAL HISTORY OF THE WAR 

The medical services of the 1st Corps were not severely 
engaged during May, beyond having to deal with the casualties 
from gas shelling of the 46th Division on the 1st, 2nd and 
22nd May. The situation was also unchanged in June, except 
for gas shelling of the 55th Division on the 9th of the 
month. 

The Xlth Corps. — The Xlth Corps at the time of the attack 

consisted of the 55th and 51st Divisions and the 2nd Portuguese 

Division. The 55th Division had just handed over to the 

1st Division of the 1st Corps the portion of its front south 

of the La Bassee Canal. The 51st Division was in reserve. 

The Portuguese were in the Neuve Chapelle sector with a 

main dressing station at Zelobes. When the Portuguese 

division was driven back a main dressing station was formed 

by a field ambulance of the 51st Division. The 55th Division 

at that time was fighting desperately at Festubert and holding 

the enemy in check, and the remaining brigades of the 51st 

Division were sent in support. Communication, however, 

regarding the medical situation was cut off. The 61st Division 

joined the Xlth Corps on the 11th April and the 50th Division 

on the 12th April, with the 5th Division in a back area. The 

line was then held by the 51st Division along the La Bassee 

Canal to Robecq, the 61st Division from there to Merville, and 

the 50th on its left, north of Merville. 

Afterwards the medical situation in the Xlth Corps remained 
more or less stabilized until the 28th June, when the 5th and 
31st Divisions attacked towards La Becque, in the area between 
Bailleul and Est aires. The number of wounded collected 
then amounted to 867, including 52 Germans. A service 
of barges on the Lys Canal between Aire and Nieppe Canal 
had been arranged for these operations. Two barges for 
twenty stretcher cases and two for eighty sitting cases had 
been allotted to the 5th Division. The barges for sitting 
cases plied between Houleron Ferry (near Tannay, half-way 
between Haverskerque and Aire), where there was a walking 
wounded collecting post, and Fort Gassion landing stage, 
the journey there and back being calculated to take one and 
a half hours only. The barges for the lying-down cases plied 
between Nieppe Forest and the same landing stage, the 
advanced dressing station being in the forest near Le Pare 
and Forester's House. Motor ambulance cars brought the 
wounded to these posts on the canal, and the barges brought 
them to the landing stage for No. 39 Stationary Hospital 
Fort Gassion. 



GERMAN OFFENSIVE ON THE LYS, 1918 261 

The Xlllth Corps. — The Xlllth Corps medical arrange- 
ments were somewhat disorganized by the headquarters of 
the corps moving to a back area and the 14th and 16th Divisions 
of the corps being employed in preparing a defensive line 
behind the First Army. Portuguese brigades were attached 
to these divisions. The 14th and 16th Divisions had been 
through the fighting with the Fifth Army and were being 
reorganized. On the 24th April the corps went into the line 
on the Aire-La Bassee Canal, taking over the 3rd and 4th 




Scene on the Canal in the Forest of Nieppe. 



Divisions in that area from the Lawe Canal north of Bethune 
to the west of Robecq, where the Xlth Corps line commenced. 
The situation on this front was fairly quiet and easy as regards 
medical services. 

The XVIIth Corps. — The XVIIth Corps, which came 
under the First Army on the 6th April, was not involved in 
the Lys offensive. As in other corps of the Army, mild influenza 
was very prevalent in it, as many as 5,956 patients being 
admitted for pyrexia of uncertain origin in the month of 
June. Of these, 117 officers and 4,533 other ranks returned 



(10134) 



U* 



262 



MEDICAL HISTORY OF THE WAR 



to duty without being evacuated to the base. At the 
beginning of the offensive of 9th April the divisions in the 
XYIIth Corps were the 4th, 15th and 56th, and subsequently 
the 15th, 51st and 56th. 

The Canadian Corps. — The Canadian Corps medical services 
in the sector between the XVIIth and 1st Corps also took 
no active part in the battles of April. It was withdrawn 
from the line in the beginning of May, when its front was 
taken over by the XVIIIth Corps from the Fourth Army 
with the 20th, 24th and 52nd Divisions, the last having only 
recently arrived from Palestine. 

The XVIIIth Corps front remained quiet during the sub- 
sequent period of the offensive, with an average of about 







Laventie Church, Estaires Front. 

twenty, ten and five wounded daily in the three divisions 
respectively during May. 

The XV th Corps. — The XVth Corps was in the First Army 
area on the left of the Portuguese and Xlth Corps on the 9th 
April, with the 34th, 38th, 40th and 50th Divisions. The 
40th and 34th Divisions were then in the line on the Laventie- 
Armentieres front, but only the 40th Division was heavily 
engaged, although both divisions suffered from mustard gas 
shells, and help had to be asked for from the Second Army 
to relieve the congestion in their field ambulances. Twenty 
lorries were sent, and the D.M.S., First Army, also sent up 
twenty-five cars to clear the dressing stations of the 40th 
Division at Doulieu and Le Vervier. The lorries of the Second 
Army cleared the wounded to its casualty clearing stations at 
Ana Jana and Remy Siding. The XVth Corps, after the attack 



GERMAN OFFENSIVE ON THE LYS, 1918 263 

on the 9th April, was reinforced by the 29th and 31st Divisions 
and it was then transferred to the Second Army on the 12th 
April. The 50th Division on its right, however, was taken 
over by the Xlth Corps of the First Army, and the 34th 
Division on its left by the IXth Corps. On the 14th April 
the 1st Australian Division came into the corps and took 
over a considerable portion of j.ts front, the other divisions 
in the corps being then the 29th and 31st. On the 16th 
April French troops began to come up on the left of the 
XVth Corps. The 9th Division joined the XV th Corps on 
the 7th May. 



18 



Ft 



Building used as advanced dressing station near Armentieres 

No. 2 M.A.C. worked with the corps till the 18th May when 
it was relieved by No. 14 M.A.C. 

During the remaining period of the offensive the chief 
casualties were from gas shells. The divisions suffered 
severely from the influenza epidemic, as many as 1,000 being 
admitted to the field ambulances on the 17th June. The 
31st Division took part in the attack on La Becque by the 
Xlth Corps on the 28th June, but this appears to have been 
the only serious engagement on the XVth Corps front since 
the first two or three days of the offensive. 



The Medical Services of the Second Army during the Offensive. 

The Casualty Clearing Stations. — The situation of the medical 
services in the Second Army was complicated by the French 
divisions, which occupied the area of some of its casualty 



264 MEDICAL HISTORY OF THE WAR 

clearing stations, more especially those at Arneke. The 
position occupied by the casualty clearing stations at Ah] 
Jana Siding was also disturbed by the advance of the enem\l 
towards Hazebrouck. Consequently the three casualty! 
clearing stations there, No. 17, No. 1 (Australian) and No. 2 
(Australian), were moved on the 13th April to Blendecques, 
just south of St. Omer, although they had only opened at 
Ana Jana a week or ten days earlier. No. 11 CCS. from 
Godewaersvelde joined them at Blendecques at the same 
time. St. Omer and its vicinity thus became the locality 
at which most of the casualty clearing stations of the Second 
Army were being concentrated. No. 11 was transferred 
from Blendecques to Moulle on the Calais road and No. 17 
to Arques Chateau on the Aire road. No. 18 was at Malassise, 
between St. Omer and Blendecques, and No. 58 at Longuenesse 
just outside St. Omer. Both these had been withdrawn to 
St. Omer by the D.M.S., First Army, from Lapugnoy and 
Lillers, and together with No. 17 at Arques came under the 
Second Army when the latter occupied the St. Omer area. 
No. 1 CCS. was also at Arques from the 13th April to 9th 
May, but was moved into the First Army area at Elnes as 
already noted. 

But in addition to the positions around St. Omer, casualty 
clearing stations were opened for the Second Army in the 
area between St. Omer and Bergues in the direction of 
Dunkerque, No. 3 (Australian) from Nine Elms and No. 2 
(Canadian) from Remy Siding were moved back to Esquelbecq 
in the middle of April, and No. 36 from Roosbrugge, No. 62 
from Bandaghem, and No. 64 from Mendinghem to Watten 
at the end of the month. 

When divisions of the French Armee du Nord occupied 
the front between St. Jans Cappel and Kemmel, the casualty 
clearing stations at Arneke were in the French Area, but, as 
the French had then no corresponding units of their own to 
which they could clear their field ambulances, the four casualty 
clearing stations there, Nos. 13, 44, 63 and 10, were receiving 
most of the French as well as British sick and wounded. 

A similar situation, as already noted, existed in connexion 
with French divisions with the Third and Fourth Armies. But 
the arrangements made with the French D.M.S. in connexion 
with the latter were not accepted by the D.M.S. of the French 
Armee du Nord. He was insistent on French personnel 
taking over British casualty clearing stations with their 
stores and equipment until a French Hopital d'Evacuation 



GERMAN OFFENSIVE ON THE LYS, 1918 265 

ould be established. This led to difficulties, because the 
:asualty clearing stations were required for the British as 
well as for the French. It was consequently arranged to 
hand over the whole of No. 63 and No. 13 C.C.Ss. to French 
personnel, leaving only the Officer Commanding, the quarter- 
master and a few other ranks R.A.M.C. in charge of the equip- 
ment. Difficulties also arose regarding the running of 
ambulance trains to Arneke, as both British and French had 
to be evacuated. British ambulance trains were only allowed 
to run there when convenient to the French authorities and 
after consultation with them. This situation was rendered 
more complicated by the fact that, owing to congestion of 
the railheads in the northern areas of the Second Army, 
British ambulance trains could not be brought up to Esquelbecq 
at the beginning of May, and the patients in the casualty 
clearing stations there had to be brought to Arneke to entrain. 
A further complication occurred in connexion with the British 
field stretchers which were being used by the French. These 
stretchers did not fit into the French ambulance transport 
and some inches of the handles of many of them were cut off 
to enable them to be used on the French cars, thus rendering 
them useless for interchanging with stretchers brought back 
in British ambulance transport. 

On the 30th April a conference was consequently held with 
the D.Q.M.G., a French representative of General Foch, the 
British liaison officer of the French Corps H.Q. in the Second 
Army area, and the D.D.G.M.S., with regard to handing over 
British casualty clearing stations to the French. It was 
arranged that the number of British sick and wounded coming 
into Arneke should be reduced and that only two ambulance 
trains should be sent there daily for the British and four for 
the French. The French authorities represented that Arneke 
was in the centre of their area, and that the railway facilities 
were not sufficient to allow of a large number of casualty clearing 
stations remaining there. 

The difficult situation was just workable. It was relieved 
when the XXIInd Corps, whose sick and wounded were being 
evacuated to the casualty clearing stations in Arneke, was 
withdrawn from the line on the left of the French divisions. 
Nos. 44 and 10 C.C.Ss. were then closed ; the former being 
transferred to Bergues on the 9th and the latter to Quaedypre 
on the 14th May, leaving Nos. 63 and 13 with the French 
until June, when the former was moved on the 9th of the month 
to Watten and the latter on the 14th to Holque. 



266 MEDICAL HISTORY OF THE WAR 

The medical services in the St. Omer and Blendecques area, 
which had been a district of the lines of communication under 
the administration of an A.D.M.S., were transferred to the 
administration of the D.M.S., Second Army, at the end of 
April, the A D.M.S. continuing under him to administer the 
area as before. The general hospitals had been withdrawn 
from St. Omer and its vicinity, namely Nos. 7, 58 and 59, 
and only two stationary hospitals, Nos. 10 and 4, the latter 
at Arques, and a voluntary hospital, No. 9B.R.C.S. (Millicent, 
Duchess of Sutherland's), together with four casualty clearing 
stations, No. 18 at Malassise, No. 58 at Longuenesse, No. 11 
at Moulle, and No. 17 at Arques, remained under this adminis- 
tration. They served as special hospitals for gassed, N.Y.D.N., 
infectious, venereal and Chinese labour patients. A voluntary 
convoy of thirty cars of the First Aid Nursing Yeomanry 
(F.A.N.Y.) was at the disposal of the A.D.M.S., St. Omer. 

The medical situation in the Second Army then was that 
two corps on the left, the XXIInd and Ilnd, were sending 
their wounded to Esquelbecq casualty clearing stations ; 
while Nos. 2 and 15 C.C.Ss. at Ebblinghem were receiving 
wounded from the XV th Corps on the right, and the two 
casualty clearing stations at Blendecques the walking wounded, 
who were being brought back from the main dressing stations 
by temporary ambulance trains. No. 18 CCS. at Malassise 
was receiving infectious cases, and No. 11 at Moulle Chinese 
sick. Three casualty clearing stations, Nos. 36, 62 and 64, 
were opening at Wat ten ; and Nos. 44 and 10 were being 
transferred from Arneke to the neighbourhood of Bergues. 
The New Zealand Stationary Hospital at Bourg (Wisques) was 
for a time being used for venereal patients, but this was stopped, 
and the venereal patients were sent instead to No. 17 CCS. at 
Arques. The 77th American Division had also at this time 
come into the army area and its medical units were taking 
over two field ambulances of the 39th Division for training. 

During May the Second Army front was comparatively 
quiet, although it was frequently bombarded by gas shells and 
suffered from air raids which caused much damage in the 
back areas, notably at St. Omer, where No. 10 Stationary 
Hospital was bombed during the night of the 21st/22nd May, 
tv/o officers and six other ranks R.A.M.C and four patients being 
killed, and eight of the R.A.M.C. and ten patients wounded. 
No. 10 Stationary Hospital was then closed and was transferred 
to a safer situation at Clerques. Most of the enemy activity 
against the front line was directed against the French divisions, 



GERMAN OFFENSIVE ON THE LYS, 1918 267 

as many as 228 of their officers and 7,156 other ranks having 
been admitted to Second Army medical units between the 
date of the arrival of the French divisions in the area and the 
22nd May. 

In June considerable changes took place in the situation of 
the medical services of the Second Army. Arrangements 
were made for the French divisions to be withdrawn towards 
the end of the month ; the XlXth and Xth Corps joined the 
Army in their place, and American divisions arrived in back 
areas for training. Nos. 2 and 15 C.C.Ss. were transferred to 
the First Army on the 27th June. 

The general situation for the disposal of sick and wounded 
of the Army was then as follows : — 

Bergues . . Nos. 10 and 44 C.C.Ss. for wounded 
of the Ilnd Corps. 

Esquelbecq No. 3 (Australian) and No 2 (Canadian) 
C.C.Ss. for wounded of the XlXth and 
Xth Corps. 

Blendecques Nos. 1 (Australian) and 2 (Australian) 
C.C.Ss. for wounded of the XVth Corps. 

The other units around St. Omer received the infectious, 
N.Y.D.N., Chinese labour and venereal cases as before, but 
gassed cases went to No. 64 CCS. at Watten. Nos. 36 and 63 
were being moved. 

Medical Services of Corps. — The corps of the Second Army 
which were chiefly engaged during the fighting of April were 
the IXth and XXIInd. The 25th, 19th, 21st and 9th Divisions 
of the IXth Corps were on the Wytschaete-Messines front 
on the 9th April ; but the corps was withdrawn, and the 9th 
and 21st Divisions were thus transferred to the XXIInd Corps. 
The remaining divisions then in the corps, 19th, 25th and 34th, 
were handed over to the VHIth Corps in reserve on 24th April 
and the IXth Corps then moved south to the Sixth French 
Army at Fere-en-Tardenois. On the 16th April the French 
divisions commenced to take over the area previously occupied 
by the IXth Corps, between the XVth and XXIInd. Neither 
the IXth nor the XXIInd Corps divisions were heavily engaged 
on the 9th April, but subsequently the brunt of the fighting 
fell on them, and especially on the 25th and 19th Divisions 
of the IXth Corps on the 10th to 16th April, and on the 9th 
Division of the XXIInd Corps on the 25th April. The 
casualties admitted into field ambulances of the 25th Division 

(10134) x 



268 



MEDICAL HISTORY OF THE WAR 



during the 10th and 15th April were as follows for each 
twenty-four hour period from 6 a.m. on 10th to 6 a.m. on the 
15th :— 



Date. 


25th Division. 


Other 
Formations. 


Total. 




Offs. 


O.R. 


Offs. 


O.R. 


Offs. 


O.R. 


10th to 11th 
11th to 12th 
12th to 13th 
13th to 14th 
14th to 15th 


31 
13 

5 
3 


992 

320 

115 

61 

43 


15 

5 

35 

15 

3 


366 
112 
753 
259 

87 


46 
18 
46 
20 
6 


1,358 
432 
868 
320 
130 



The 25th Division was withdrawn from the line on the 
15th April, but moved up to counter-attack at Kemmel on 
the 26th April. The division joined the IXth Corps at 
Fere-en-Tardenois on the 8th May. 

The 19th Division was actively engaged on the Kemmel 
front till the 18th April, when its front was taken over by the 
•French 28th Division, but the field ambulances of the 19th 
Division continued to work for the French until the 21st 
April. The losses in the medical personnel of this division 
during these operations were 1 officer and 23 other ranks 
missing, 10 other ranks killed, and 27 other ranks wounded. 
Four motor ambulance cars were totally destroyed by shell 
fire. The other casualties in the division were 33 officers 
and 872 other ranks admitted to its own field ambulances, 
and 21 officers and 792 other ranks admitted to field ambu- 
lances of other divisions. In addition, 60 officers and 1,952 
other ranks from other formations passed through 19th 
Division field ambulances. 

Field ambulances of the divisions of the IXth and XXI Ind 
Corps, as the British front was driven back, were gradually 
concentrated at Remy Siding. Main dressing stations for 
stretcher cases were opened there by several divisions. 
Walking wounded were taken farther north to the casualty 
clearing station site at Mendinghem. The wounded were 
admitted into main dressing stations of divisions indiscri- 
minately, and this accounted for the large numbers of wounded 
of other formations who were received into the field ambulances 
of the 25th and 19th Divisions. 

The 34th Division, which was on the left of the XV th Corps 
in front of Armentieres when the German offensive was 



GERMAN OFFENSIVE ON THE LYS, 1918 269 

launched, was heavily shelled with gas shells on the 8th ApriL 
It was estimated that about 20,000 gas shells were thrown 
into the town. The main dressing station of the division 
fell back to No. 2 CCS. site at Oultersteene on the 10th ApriL 
The wounded and gassed were evacuated through Nieppe. 
On the night of the 12th/13th the 34th Division relieved the 
25th Division and held the line north-east of Bailleul until 
it in its turn was relieved by French divisions on the 21st April. 
At Oultersteene a large amount of stores and equipment of 
the casualty clearing stations had been left behind but much 
of it was salved by the XVth Corps medical units. 



Ambulance Transport during the Offensive. 

There were few special incidents in connexion with the 
work of the ambulance transport of divisions and convoys. 
The First Army had Nos. 2, 8, 12, 13, and 25 M.A.Cs., and 
the Second Army Nos. 4, 5, 6, 14 and 20 M.A.Cs. These 
were distributed to corps or held as Army reserve, and as had 
now become a recognized custom they were supplemented by 
lorries for bringing walking wounded back. The light 
ambulance wagons of the field ambulances were in some 
cases able to go forward as far as the regimental aid post 
positions, and much use was also made of the horsed ambulance 
wagons for the sitting casualties. As in the retreat on the 
Somme, the roads leading to the fighting line were much less 
damaged than in those battles in which the British line advanced 
instead of falling back. The usual complaints were made of 
the difficulty in getting wounded away from advanced dressing 
stations when the field ambulance transport was ordered — 
as they were ordered in one corps — to take the wounded 
back to casualty clearing station positions instead of to main 
dressing stations. This procedure was noted in A.Ds.M.S. 
diaries to interfere seriously with clearing the front areas 
and was a repetition of what gave rise to similar complaints 
by divisional A.Ds.M.S. in previous battles, as well as being 
contrary to the principles laid down by the D.G.M.S. in his 
memorandum of 2nd April. The depth of the German advance 
at its farthest point was not more than ten or eleven miles, 
as compared with forty to fifty in the offensive on the Somme, 
and consequently the distance from the front line to the 
casualty clearing stations in the back area became relatively 
greater when the advance was checked. 



270 MEDICAL HISTORY OF THE WAR 

The Casualties. 

The casualties admitted into the medical units of the First 
and Second Armies from the 8th April onwards are shown 
in the following table. 

Casualties admitted to First and Second Army medical units 
during the Lys Offensive in April. 





Field 


Casualty Clearing 




Ambulances. 


Stations. 


Date. 








First 


Second 


First 


Second 




Army. 


Army. 


Army. 


Army. 


1918. 










8th April . 






1,354 


28 


1,642 


61 


9th , 










3,426 


63 


3,797 


636 


10th , 










? 


1,391 


2,506 


3,321 


11th , 










2,271 


1,296 


2,271 


4,198 


12th , 










? 




1,759 


3,580 


13th , 










? 




862 


2,840 


14th , 










? 




638 


1,666 


15th , 










? 




710 


1,444 


16th , 










? 




328 


2,527 


17th , 










? 


2,362 


400 


2,987 


18th , 










? 


1,146 


1,419 


1,869 


19th , 








. 


? 


516 


483 


748 


20th , 








. 


? 


412 


467 


546 


21st 










523 


530 


458 


593 


22nd , 










635 


368 


720 


553 


23rd , 










566 


456 


599 


673 


24th , 










512 


365 


587 


823 


25th , 










496 


720 


520 


4,064 


26th , 










395 


1,317 


446 


2,446 


27th , 










? 


845 


199 


1,755 


28th , 










? 


598 


439 


712 


29th , 










319 


1,640 


378 


2,000 


30th , 










? 


378 


246 


769 



The large number of casualties in the First Army on the 
8th April was mainly due to the gas attack on the 34th Division 
on the Armentieres front. Afterwards, what had been the 
normal line of evacuation of the 34th and 40th Divisions of the 
XVth Corps, namely, to casualty clearing stations at Havers- 
kerque, became a line running parallel to the line of the enemy's 
advance, and consequently the wounded of the XVth Corps 
divisions had then to be evacuated in the direction of Haze- 
brouck, Godewaersvelde, or Remy Siding, the main dressing 
stations retiring in the same direction, at first towards 
Oultersteene. This fact accounts for the comparatively 



GERMAN OFFENSIVE ON THE LYS, 1918 271 

large number of wounded received into the Second Army 
casualty clearing stations after the 9th April. Thus the 
40th Division, which was in the XV th Corps until the 12th 
April, and the Xlth Corps until the 14th, had collected some 
1,596 wounded, who were evacuated to Hazebrouck or 
northwards to Remy Siding between the 9th and 14th April. 
On the Aire-La Bassee Canal front the direction of eva- 
cuation was at first through main dressing stations in the 
Seminaire St. Vaast at Bethune, until they were shelled out 
on the 10th April, and afterwards through Chocques to the 
casualty clearing stations at Lozinghem and Pernes. The 
Xlth Corps front at the point of the salient was cleared through 
main dressing stations at Busnes and Ham-en-Artois in the 
direction of St. Omer and Pernes. The medical units of the 
55th Division, which held its ground along the La Bassee 
Canal, received most of the wounded from the southern area. 
Between the 9th and 16th April its field ambulances admitted 
a total of 119 wounded officers and 2,403 other ranks, of 
whom 47 officers and 1,032 other ranks belonged to other 
divisions. 

Casualties amongst the Civil Population. 

In reviewing the work of the medical services during the 
Lys offensive certain features stand out in contrast with the 
work of the medical services in the Somme offensive during 
the previous month. The Fifth and Third Armies went 
back under the enemy pressure in March over the de- 
vastated area of the Somme battles of 1916 ; whereas the 
area through which the enemy forced back the British, 
Portuguese and French in the First and Second Army areas 
in April had been more or less undamaged by battle since 
the British occupied the line between Armentieres and the 
Aire-La Bassee Canal in 1914. There were many towns and 
villages in this area, and few of the civil inhabitants had 
left their homes. Consequently Bethune, Estaires, Merville, 
Armentieres and numerous villages were full of old men, 
women and children when the German attack was launched. 
It thus happened that when these places were shelled and 
bombed, and more especially when enormous numbers of 
gas shells were thrown into Armentieres and Bethune, the 
casualties amongst the civil inhabitants were extremely 
numerous and distressing. British medical units and ambu- 
lance convoys at once came to their assistance, and were 
actively engaged in bringing the sick, wounded and helpless 



272 MEDICAL HISTORY OF THE WAR 

civilians back to places of safety. For example, No. 1 M.A.G. 
had been sent up to Bethune from G.H.Q. by the D.G.M.S. 
and brought back a large number to the French hospitals at 
Hesdin. Again, St. Venant Asylum, whose director, Dr. Cortyl, 
had throughout the war been indefatigable in providing 
accommodation for and assisting the Indian, British and 
Portuguese casualty clearing stations which occupied in turn 
a portion of the buildings, was full of insane women. It was 
being heavily shelled and had become untenable, except by 
an advanced dressing station. The 61st Division had opened 
a main dressing station there on the 12th April, but had to 
withdraw it on the following day. There were then 870 
mental cases in the asylum together with the staff, and some 60 
women and children in a neighbouring hospice. These were 
all evacuated under the supervision of the D.D.M.S. of the 
XI th Corps. They were taken from St. Venant in lorries 
and entrained at Berguette between 1 a.m. and 9.30 a.m. 
on the 15th April. 

As an instance of how little did the inhabitants of the villages 
in the area of the 55th Division anticipate the impending 
disaster, the A.D.M.S. of the Division notes that he had to 
clear bedridden civilians from cellars in the Chateau of La 
Gorre on the canal in front of Bethune on the 11th April, 
at a time when his regimental aid posts and advanced dressing 
stations were strung out along the Canal between Bethune 
and Givenchy. 



CHAPTER XVI. 

THE BRITISH MEDICAL SERVICES WITH THE FRENCH ON 
THE AISNE AND THE MARNE, MAY TO AUGUST 1918. 

WHILE the German offensives were being made on the 
British line in front of Hazebrouck from April to June 
1918, there was considerable activity farther south. Severe fight- 
ing took place around Villers Bretonneux on the 24th and 25th 
April, in which the elements of the 18th and 8th Divisions 
of the Illrd Corps on the right and of the 3rd and 4th Austra- 
lian Divisions of the Australian Corps in the centre and on the 
left were engaged. The Fourth Army, in which these corps 
were at the time, had its casualty clearing stations along the 
Somme Valley between Amiens and Abbeville, chiefly at 
Longpre, Picquigny, Pernois, Crouy and Vignacourt. The 
number of wounded was comparatively small and the general 
organization and scheme for their collection and evacuation 
presented no difficulties. 

The German Offensive on the Aisne. 

A different situation, however, arose in connexion with the 
British divisions of the IXth Corps which formed part of the 
Sixth French Army on the Aisne front. These divisions had 
passed through a period of severe fighting and had been trans- 
ferred to a quiet area for rest and training in exchange for the 
French divisions sent to support the right of the British line on 
the Flanders front. Three of the divisions, the 21st, 8th and 
50th, were put into the French front line, during the first 
fortnight of May, on a front of about fifteen miles between 
Bermicourt and Bouconville, north-west of Rheims. The 
25th Division was in reserve. The French Sixth Army was 
attacked by overwhelming numbers from Rheims to Soissons 
at 1 a.m. of the 27th May. The whole of the IXth Corps 
front was thus involved, as well as the French Corps holding 
the Chemin des Dames on its left. The fighting continued 
for several days, all the divisions of the IXth Corps being 
engaged. The line was forced back to the Marne, the IXth 
Corps being pressed back on the centre and left " to a position 



274 MEDICAL HISTORY OF THE WAR 

facing west and north-west between the Aisne and the Vesle."* 
On the 28th May the corps retired across the Vesle and Ardres. 
The 19th Division, which had been with the VHIth Corps in 
reserve, was then brought up in buses to fill the gap between 
the IXth Corps and French on its left. The British divisions 
then came under the command of the French Fifth Army 
and withdrew to the line Aubilly-Chambrecq-Boujacourt. 

The Medical Services of the IXth Corps during the German 
Offensive on the Aisne. 

The medical services with the IXth Corps during these 
operations were administered by Colonel R. J. Blackham, 
who had succeeded Colonel J. B. Wilson as D.D.M.S. of 
the Corps on the 17th May. He had with him two casualty 
clearing stations, the 37th and the 48th, the former from Italy 
under Lieut-Colonel Gray, and the latter, under Lieut. -Colonel 
Henchley, from Ytres after it had been refitted at Boulogne. 
The D.D.M.S. 's office was opened at Fere-en-Tardenois on the 
27th April. No. 37 CCS. was placed in huts in a section of 
a French Hopital d' Evacuation at Mont Notre Dame on the 
following day, but infectious cases were sent to French medical 
units at Jouaignes or Igny l'Abbaye, and continued to be 
sent there. No. 48 CCS. left Boulogne on the 16th May 
and arrived on the 19th at Montigny-sur-Vesle, where it also 
took over a part of a French Hopital d'Evacuation. It 
opened for admission of patients on the 23rd May. 

In anticipation of the attack, Colonel Blackham had prepared 
a well thought out scheme under the administrative control 
of the D.M.S. of the French Sixth Army. He did not hear 
of the impending attack, however, till 6 p.m. of the 26th May. 
He then met the A.Ds.M.S. of divisions and the officers com- 
manding the casualty clearing stations and other medical 
units. A.Ds.M.S. were instructed to work their field ambu- 
lances in echelon and be prepared to move back rapidly in 
the case of a hostile advance. This echelon scheme was 
designed to* bring the main dressing stations gradually back 
to and behind the divisional rest stations. The main dressing 
stations would thus be established in echelons, and as each 
field ambulance retired it formed a new post to which wounded 
were taken for evacuation farther back. An important 
instruction was that the divisional motor ambulance cars 
were not to proceed farther back than these main dressing 
station positions. 

* Sir Douglas Haig's despatches, p. 253. 



French 



SKETCH MAP OF MEDICAL SITUATION OF FRENCH SIXTH ARMY 

ON THE A1SNE. 

MAY 2QTH 1918 . 

Showing the relative positions of BrTush and French formations. 

'Boundary of zone of Army WWW//M Corps Boundary «•»««« Divisional Boundary 




Posts for treatment of V.D. 
Divisional Ambulances. 
Corps D? 

Army D? 

Stationary Hospital. 

m Casualty Clear inc/ Stat/ 

Hospital Centres on the L.of C. 



BRITISH UNITS . 
Main Dressing or Divsnl. Rest Station 

Casualty Clear inc/ Station. 



MaJby&Sons.bTJi 



Medical Situation of the British IX Corps with the Sixth 
French ArmyontheAisne, German offensive , May 27 t . h 1918. 



+ Regmntl.A/d Post. 

• R.A.M.C Bearer Post. 

Car Loading Point. 

Q Adv. Dressing Station. 

JJ Main Dressing Station. 

£ Dvsni. . Pest Sta t/on. 

A Casualty Clearing Station. 



Re&imental.Stretcher Bearers 

— Hand Carriage, R.A.M.C. Bearers. 
-m* Railway. 

— Amovi-ance Cars. 

— Oo . Da . f Might only). 




15. 284-8 C.50GO/ I'M. ISOO.ll'Z'i. 



H.M SO., Cr 



MEDICAL SERVICES WITH THE FRENCH 275 

The motor ambulance convoys at Colonel Blackham's 
disposal for evacuating from the main dressing stations to 
the casualty clearing stations were No. 31, which was with 
him from the 4th May, and No. 42, which arrived from the 
lines of communication on the 28th May in response to a 
message sent on the night of the 26th May for an additional 
motor ambulance convoy. A lorry convoy of thirty lorries 
had also been organized and placed under an officer of the 
R.A.M.C. 

Arrangements had been made with the French for British 
ambulance trains to run to the British casualty clearing 
stations, but the arrangements had not come into effect when 
the operations commenced. A telegram was sent to G.H.Q. at 
8 p.m. on the 26th asking for two trains to be sent to the corps 
area at once and for six others to be within reach. The Q.M.G. 
at G.H.Q. had informed the IXth Corps Commander that 
there should be no difficulty in getting eight ambulance trains 
up every twenty-four hours, but asked that the details should 
be arranged with the French Sixth Army. 

The instructions to the casualty clearing stations were to 
clear the walking wounded first, and to have their equipment 
ready for transport back by train or lorry. The personnel 
of the casualty clearing stations were given a rendezvous at 
Fere-en-Tardenois in the event of their having to withdraw. 
No. 17 Advanced Depot of Medical Stores, which had 
arrived in the IXth Corps area on the 10th May and had 
been established with No. 37 CCS. at Mont Notre Dame, 
was given the same rendezvous in the event of a retirement 
being necessary. 

The other medical units with the corps were No. 16 (Bacterio- 
logical) and No. 22 (Hygiene) Mobile Laboratories. The former 
was with No. 37 CCS. and the latter with No. 48 CCS. 
There were also an X-ray unit with No. 48 CCS. and a dental 
unit with No. 37. 

The IXth Corps medical units were thus either at Mont 
Notre Dame behind the left, or at Monti gny-sur-Vesle behind 
the right of the IXth Corps front, at a distance of some seven- 
teen and seven miles respectively from the front line. The 
divisional medical units and two sanitary sections, Nos. 45 
and 119, were occupying various villages between them and 
the front. It should be noted, however, that Mont Notre 
Dame was outside the area assigned to the IXth Corps by 
the staff of the French Sixth Army, who had fixed the localities 
to which the casualty clearing stations should be sent. 



276 MEDICAL HISTORY OF THE WAR 

When the attack commenced steps were taken at once to 
withdraw No. 48 C.C.S., as it was nearest the line, but only 
two lorry loads were got away to Fere-en-Tardenois, about 
thirty miles behind the line. Wounded poured into No. 48 
CCS. during the day. Five hundred were evacuated by a 
French ambulance train at 1 p.m. The train got away 
just before the line was cut at Fismes. About 1,500 patients 
were dealt with and cleared from this casualty clearing 
station up to 6 a.m. on the 28th May. The unit was then 
abandoned, the entire personnel and lorries escaping before the 
position was captured. Forty severely wounded had to be 
left behind. 

The rapid advance of the enemy towards Mont Notre Dame 
was unforeseen and came as a surprise. The railway line was 
cut at 10 p.m. on the 27th May, so that evacuation by ambu- 
lance train was impossible, but a French ambulance train 
had already cleared 500 British wounded from No. 37 CCS. 
The walking wounded were sent to Fere-en-Tardenois, and 
arrangements were made to send off in cars and lorries whatever 
material and personnel could be spared from the service of 
the wounded. These arrangements, however, fell through, 
as the Germans entered the hospital at 1.30 a.m. on the 
28th May and all communications were broken. The whole 
of the British and French casualty clearing stations and their 
wounded were thus captured together with their personnel. 
Four R.A.M.C officers, one dental surgeon, three chaplains 
and six other ranks of No. 37 CCS., however, got away. 
The Commanding Officer, Lieut-Colonel Gray, four other 
R.A.M.C. officers, the Quartermaster and the rest of the unit 
remained with the wounded. No. 17 Advanced Depot of 
Medical Stores was also captured. The other units got away 
to the rendezvous at Fere-en-Tardenois. 

After these events and until the German advance was 
checked, British wounded were received into French hospitals 
during the different stages of the retreat, the personnel of 
No. 37 and No. 48 C.C.Ss. or of a field ambulance being attached 
for duty in them. The evacuation hospitals were thus 
successively at Dormans on the 28th May, Chateau-Thierry, 
Dormans and Epernay on the 29th, Dormans, Epernay and 
Vertus on the 30th, Epernay and Vertus on the 1st and Vertus 
on the 2nd June. 

British ambulance trains were able to come up to clear 
the British wounded from Dormans on the 29th May, but 
throughout the operations many of the wounded were cleared 



SKETCH MAP OF THE MEDICAL SITUATION OF THE BRITISH IX CORPS WITH 
THE SIXTH FRENCH ARMY ON THE AISNE, DURING THE GERMAN OFFENSIVE, MAY-JUNE 1918. 



© Advanced Dressing Station. 
H Main Dressing Station. 




Malby&Sons.Lith. 



MEDICAL SERVICES WITH THE FRENCH 277 

by the French in cars and ambulance trains in a southerly 
direction to French hospitals, their destination being deter- 
mined by the French authorities. 

The Vlllth Corps was in reserve behind the IXth Corps 
with headquarters at Chalons-sur-Marne during these opera- 
tions. No. 62 CCS. was established with it at Bussy- 
le-Chateau, and on the 9th June, No. 32 CCS. was sent up 
and opened under the IXth Corps administration at Sezanne. 
Wounded were taken to the former by motor transport from 
Epernay on the 29th and 30th May, and to the latter both 
by ambulance transport and ambulance trains at a later 
date. 

The situation and movements of the medical units and the 
evacuation of sick and wounded from them may be followed 
from the sketch maps. 

The chief difficulties were the short notice of the attack, 
lack of information during the battle, and the rapidity of the 
enemy's movements. The D.D.M.S. of the IXth Corps 
received information of the impending attack less than eight 
hours before it took place. At that time the field ambulances 
were in buildings or huts which had been taken over from 
the French when the British divisions went into the line. The 
accommodation in them was so good and ample that divisions 
were inclined to retain in them as many cases of sickness as 
possible in order to avoid wastage. The result of this was 
that 1,023 sick were in the divisional areas when notice of 
the attack was received. Many were at once returned to duty, 
but the casualty clearing stations were immediately filled 
with and hampered by the reception of some 400 or 500 of 
these cases. Further, No. 37 CCS. was outside the corps 
boundary, and the D.D.M.S. was not aware of its position 
being threatened until 6 p.m. of the 27th May. Attempts 
then to communicate with it failed owing to the enemy having 
come between it and corps headquarters. The D.D.M.S., in 
ignorance, therefore, of what was happening on the left flank, 
concentrated his attention on clearing No. 48 CCS. which 
was much nearer the front line. No. 37 CCS. was so far 
back that it seemed inconceivable that its position would be 
threatened during the first twenty-four hours. The advance 
of the Germans of twenty-nine miles in one day was in fact 
entirely outside the experience of the offensives against the 
British fronts on the Somme and the Lys. 

The number of wounded and sick received into the field 
ambulances and casualty clearing stations of the IXth Corps 



278 



MEDICAL HISTORY OF THE WAR 



from the 27th May to 19th June was as follows, exclusive of 
those in No. 37 C.C.S. at the time of capture : — 





Sick. 


Wounded. 




Ofifs. 


O.R. 


Offs. 


O.R. 


Field ambulances 
Casualty clearing stations 


116 

88 


2,122 
1,947 


170 
170 


4,457 
4,292 



The motor ambulance convoys cleared 8,102 and ambulance 
trains 11,944; of whom 6,517 went to British hospitals at 
Rouen and the others to French hospitals in various parts 
of France. No. 31 M.A.C. had the greatest strain thrown on 
it during the first two days, until it was relieved by No. 42 
M.A.C. The numbers missing were reported to be 773 officers 
and 11,147 other ranks, and the numbers killed, 98 officers 
and 454 other ranks. 

The losses in medical personnel were correspondingly great. 
They were as follows : — 





Killed. 


Wounded. 


Missing. 


Officers 
Other ranks 


3 
15 


4 
80 


45 
497 



The missing included the A.D.M.S., Colonel Milne-Thompson, 
of the 50th Division and his D.A.D.M.S. 

The loss in British medical equipment and stores was not 
so great, as much of the equipment used belonged to the 
French medical units in the localities taken over by the 
British. No. 25 Field Ambulance of the 8th Division, No. 37 
C.C.S. and No. 17 Advanced Depot of Medical Stores were in 
fact the only units which were captured intact. The losses 
in ambulance transport between the 27th May and 2nd June 
were, however, considerable. The 50th Division lost twelve 
of its motor ambulance cars, the 8th Division eleven, and 
the 21st and 25th Divisions one each. No. 31 M.A.C. lost 
seven cars. Five horsed ambulance wagons were also lost, 
three in the 8th Division and two in the 21st. There was 
also a loss of twenty-five stretcher carriers in the divisions. 

While the IXth Corps was thus engaged with the French 
on the Aisne front, the VHIth Corps with the 19th Division 
only had its headquarters at Chalons-sur-Marne, where its 



MEDICAL SERVICES WITH THE FRENCH 279 

D.D.M.S., Colonel Shanahan, was in close touch with the 
administrative medical officers of the French Fourth Army. 
The A.D.M.S. of the 19th Division had opened his office at 
St. Germain la Ville. No. 62 C.C.S., which had been sent to 
the French front with the VHIth Corps, after several sites 
had been proposed was eventually placed in a French hospital 
at Bussy-le-Chateau. No. 11 M.A.C., No. 19 Advanced 
Depot of Medical Stores and No. 14 X-ray Unit were also 
with the Vlllth Corps at this time. The 19th Division was 
transferred to the IXth Corps on the 28th May, as noted 
above. Many British wounded from the Aisne front were 
then being received into French hospitals at Chalons, and 
the D.D.M.S. of the Vlllth Corps had his time occupied in 
arranging for their transfer to No. 62 CCS. This was carried 
out by No. 11 M.A.C 

On the 4th June No. 19 Advanced Depot of Medical Stores 
was transferred from the Vlllth to the IXth Corps and placed 
at Sezanne. 

In order to co-ordinate the work of the British units in 
the French areas a G.H.Q. (South) was now formed, and on 
the 5th June Colonel Shanahan, the D.D.M.S. of .the Vlllth 
Corps,* was appointed D.D.M.S. at this G.H.Q. for adminis- 
tering the British medical services. His headquarters were 
at La Ferte Gaucher. 

The Medical Situation after the German Offensive. 

The IXth Corps remained with the French on the Marne 
front until the 5th July, when it was transferred to the Fourth 
Army and occupied the area behind the junction of the French 
and British on the Amiens front, replacing the XXIInd Corps, 
which was then transferred to the area previously occupied 
by the IXth Corps on the Marne. No. 32 CCS. had been 
sent to the IXth Corps area, after having been refitted at 
Etaples, on the 9th June, and was established at Sezanne, 
with the personnel of No. 48 CCS. attached to it. On the 
25th June, No. 48 CCS. was sent to Rouen to refit, and No. 32 
CCS. was transferred to the reconstituted Fifth Army and 
opened at Elnes near St. Omer. No. 62 CCS. was transferred 
to the Second Army and went to Arneke. No. 31 M.A.C 

* The Vlllth Corps left for Long, eight miles east of Abbeville, in the Fourth 
Army back area, on the 15th June, where the 8th and 21st Divisions came 
under its administration. No. 62 CCS. was, however, left with the IXth 
Corps at Bussy-le-Chateau. On the 24th June the Vlllth Corps as a corps 
was broken up and ceased to function. 



280 MEDICAL HISTORY OF THE WAR 

went to the First Army and No. 42 M.A.C. to G.H.Q. (Hesdin). 
No British medical units were thus left with the French on the- 
departure of the IXth Corps. Consequently, when the XXIInd 
Corps arrived about fourteen days later it brought with it 
fresh medical units. Its divisions were the 51st and 62nd. 
No. 48 C.C.S., after being re-equipped at Rouen, joined it at 
Vertus on the 21st July. No. 50, which had been refitting 
at Etaples after the Somme offensive, was also sent to the 
XXIInd Corps and opened at Sezanne on the 19th July. It 
had with it No. 31 Advanced Depot of Medical Stores and 
No. 13 Mobile X-ray Unit. Nos. 42 and 44 M.A.Cs. were 
also attached to the XXIInd Corps in July, but the latter 
was held in reserve by the D.D.M.S., G.H.Q. (South). 

Two British divisions, the 15th and 34th, were attached 
to the French Groupe d'Armees de Reserve (G.A.R.) formed 
of the French Third and Tenth Armies. Both divisions 
were placed with the Tenth Army, the 15th with the French 
XXme Corps d'Armee, and the 34th with the XXXme Corps 
d'Armee. Nos. 16 and 17 M.A.Cs.; No. 63 CCS. and No. 3 
Advanced Depot of Medical Stores were sent to work with 
them, the two latter units to Senlis. They were thus in the 
area behind the Forests of Compiegne and Villers Cotterets. 
The medical administration of the XXIInd Corps and the 
British units with the G.A.R. was then co-ordinated by the 
D.D.M.S., G.H.Q. (South), at La Ferte Gaucher. Colonel 
C. E. Pollock had at that time replaced Colonel Shanahan, 
but a D.D.M.S., Colonel T. P. Jones, was appointed specially 
as D.D.M.S. of the British Forces with the French G.A.R. 
owing to the distance between the XXIInd Corps units and 
the 15th and 34th Divisions. His headquarters were at CreiL 
For general administration he came under Colonel Pollock, 
but he did not take up his appointment until the 25th July. 
Up till then the arrangements for medical units behind the 
15th and 34th Divisions were being made by Colonel S. Gallie, 
from the L. of C, under Colonel Pollock's direction. 

The French Offensive on the Marne. 
After the close of the operations in which the IXth Corps 
had been engaged, the allied counter-offensive, which marked 
the commencement of the advance to victory, was launched 
by the French Groupe d'Armees de Reserve " on the front 
between Chateau Thierry and Soissons," supported " by 
vigorous attacks on other parts of the German Salient."* 

* Sir Douglas Haig's despatches, p. 255. 



MEDICAL SERVICES WITH THE FRENCH 281 

The 51st and 62nd Divisions of the XXI Ind Corps and the 
15th and 34th Divisions with the French Tenth Army were 
involved in these attacks on the right and left of the French 
main attack. The XXIInd Corps had just arrived at Vertus 
when the operations commenced. The 51st and 62nd Divisions 
went into the line on the 19th July, and attacked at dawn 
the following day. The fighting continued on this front till 
the 28th July, and resulted in the recovery of the positions 
from which the IXth Corps had withdrawn in the previous 
fighting at the end of May and beginning of June. The 
divisions were then relieved and entrained with the XXIInd 
Corps for the British zone between the 2nd and 4th August. 

The two British divisions, the 15th and 34th, with the 
French Tenth Army went into the line on the night of the 
22nd/23rd July, and attacked on the left flank of the salient 
at Berzy-le-Sec and Parcy Tigny, south-west of Soissons. 
They continued operations in that area. The fighting was 
especially heavy on the morning of the 29th July at Buzancy, 
when the 34th Division was moved southwards to a line facing 
Oulchy-la-Ville, and the 15th Division to a line in front of 
Villemontoire. The attack was continued in that area on the 
morning of the 1st August. The divisions were relieved on 
the night of the 3rd/4th August and entrained for the British 
zone on the 5th August. 



The Medical Services with the XXIInd Corps during the 
French Offensive. 

The medical arrangements of the XXIInd Corps during these 
operations are indicated in the sketch map on the next page. 

No. 50 CCS. arrived at Sezanne with mobilization equip- 
ment only, that is, for 200 beds, but this was supplemented 
by the French. No. 48 CCS. at first went to Vertus, but on 
the 24th July a detachment was sent to the Hopital Auban 
Moet, Epernay, to form an advanced operating centre, in 
conjunction with a field ambulance already there. The 
remainder of No. 48 then took over a hospital at Chaltrait-au- 
Bois of 300 beds from the Italians, who with American 
troops were also with the French armies in Champagne. This 
hospital was between Vertus and Montmort, nine miles south 
of Epernay, and was used for walking wounded, gassed cases 
and sick. Sezanne was still farther south, about fifteen miles 
from Epernay. 



282 



MEDICAL HISTORY OF THE WAR 



Sketch map showing posit ions of medical, posts of 
the 5l^ T &62 N PDvsws.(§[iJ Corps) with the Sixth 
French Army, during operations of July 1918, on 
the Eastern flank of the Marne salient. 




■■-¥ 4^%*^£ 



Sc*i/& o? /T>//<& S 




Vertus. 



MEDICAL SERVICES WITH THE FRENCH 283 



The Casualties.— The number of wounded collected by the 
divisions of the XXIInd Corps between the 20th and 29th 
July is not very clearly recorded, but the D.D.M.S. of the 
corps notes the following as having been evacuated from the 
field ambulances to casualty clearing stations from the 21st 
July onwards : — ■ 

21st July 1,312 



22nd 
23rd 
24th 
25th 
26th 
27th 
28th 
29th 
30th 
31st 



819 
415 
953 
180 
72 
102 
387 
367 
148 
157 



The main dressing station of the 51st Division records the 
admissions of 101 officers and 1,466 other ranks between 
the 20th and 31st July, and the main dressing station of the 
62nd Division 2,077. 

The two motor ambulance convoys, Nos. 42 and 44, were 
working from Epernay and Vertus in evacuating wounded 
from the main dressing stations to Nos. 48 and 50 C.C.Ss. 
The French also provided a number of lorries for the evacua- 
tion of walking wounded. 

Some of the British casualties were also taken by an Ameri- 
can ambulance train to an American hospital in Paris on the 
23rd July. 

The whole of the arrangements for clearing the casualty 
clearing stations was controlled by the French authorities. 
Both British and French ambulance trains were employed. 
While the British trains ran from the front to Rouen, 
the French trains took the wounded to various French 
hospitals at Chalons, Bar-le-duc and elsewhere, but chiefly 
to Troyes, which was only some thirty miles south of Sezanne. 
The A.D.M.S., Colonel Statham, of the British Paris adminis- 
trative area, was in close liaison with Colonel Pollock, the 
D.D.M.S., G.H.Q. (South), and the movements of the British 
sick and wounded to Troyes and elsewhere were regulated 
in such a manner that transfer from the French hospitals 
to Rouen was being continuously effected. 

(10134) X 



284 MEDICAL HISTORY OF THE WAR 

Colonel Owen Richards was attached to G.H.Q (South) as 
consulting surgeon during the operations. Surgical teams 
and nursing sisters were brought up to No. 48 CCS. advanced 
operating centre at Epernay, the latter on the 29th July. 
At No. 50 CCS. much assistance was given by the French 
operating surgeons, and also by women drivers of a convoy 
of the First Aid Nursing Yeomanry working with the French, 
who took on duties of nursing at the casualty clearing station. 

The Work of the Field Ambulances. — The two casualty 
clearing stations and the motor ambulance convoys were not 
ready for work on the night of the 19th/20th July. Conse- 
quently the tent division of a field ambulance of the 62nd 
Division acted as a casualty clearing station at Sezanne and 
the tent division of a field ambulance of the 51st Division at 
Auban Moet, Epernay, during the 20th July. The main dressing 
stations of the 62nd Division were at St. Imoges, with a walking 
wounded dressing station at Champillon. The motor ambu- 
lance convoy cars began to work during the afternoon of the 
20th, but were not in full working order till the 22nd. Con- 
sequently considerable numbers of the lying down wounded 
were held up at St. Imoges till then. 

In the absence of an advanced depot of medical stores 
at the commencement of the operations, there was difficulty 
in maintaining an adequate supply of ' dressings, splints and 
anti-tetanic serum at the main dressing stations, but much 
assistance was obtained from the French. 

The country was thickly wooded, and while this allowed 
ambulance cars to come up, free from enemy observation, 
much farther forward than on previous occasions, the bearers 
found it specially difficult to find their way in the forest country. 
Bandages were tied round the trees to mark the routes for 
the stretcher bearers and walking wounded and this proved a 
very effective and valuable method in wood fighting. 

The regimental aid posts of the 51st Division were in the 
Bois de Courton on the 20th July, with collecting posts to 
which the cars could come up at Courton Ruine on the left 
and at a hill outside Nanteuil on the right. The advanced 
dressing station was at St. Imoges, and the main dressing 
station at Champillon. During the fighting the collecting 
posts to which cars could run advanced to St. Denis, then 
to Marfaux, and finally to Chaumuzy. Two or more relays 
of bearers worked through the wood to these car posts. The 
main dressing station advanced to St. Imoges and the advanced 
dressing station to Nanteuil. 



MEDICAL SERVICES WITH THE FRENCH 285 

The British Medical Services with the French Tenth Army 
during the Offensive. 

When the 15th and 34th Divisions with the French Tenth 
Army attacked on the morning of the 23rd July they were 
separated from one another by two French divisions, so that 
it was difficult to co-ordinate the arrangements for the eva- 
cuation of their wounded. 




At No. 63 Casualty Clearing Station, Senlis, 1918. 



No. 63 CCS. detrained at Senlis on the night of the 22nd/23rd 
July. It opened in the College St. Vincent, Senlis, and was 
ready to receive the first convoy of wounded which arrived 
at 6 a.m. on the 23rd. It had been fully equipped by the 
French, had accommodation for over 1,000 patients, and was 
also conveniently near the railway station from which ambu- 
lance trains ran direct to Rouen. Twelve French voluntary 
aid nurses continued to serve in it, and were of great assistance 
to the British nursing sisters of the unit. As this was the only 
casualty clearing station serving the two divisions the work 



(10134) 



Y* 



286 



MEDICAL HISTORY OF THE WAR 



was very heavy, especially in connexion with the unloading 
of cars and entraining wounded. Consequently, fifty men of 




"Gas" ward in No. 63 Casualty Clearing Station, 
Senlis, July 1918. 

the R.A.M.C. from field ambulances, fifty V.D. convalescents, 
and forty-two other convalescents were attached to the unit 
to assist in this work on the 26th and 28th July. 






MEDICAL SERVICES WITH THE FRENCH 



287 



A walking wounded post for both divisions was established 
at Halte St. Remy, three-quarters of a mile from Villers 
Cotterets on the road to Puiseux. A tent sub-division from 
each of the two divisions was stationed there with twenty 
marquees from No. 63 CCS. 




Corridor at College St. Vincent, Senlis, 
No. 63 Casualty Clearing Station, July 1918. 



The main dressing station of the 34th Division was at Largny, 
twenty-three miles from Senlis, with an advanced dressing 
station at Montremboeuf Farm, near Villers Helon. When 
the division moved to Oulchy-la-Ville area, the main dressing 
station was established at Chouy with an advanced dressing 



288 



MEDICAL HISTORY OF THE WAR 



station at Billy-sur-Ourcq, and afterwards at Oulchy-la-Ville. 
The Largny main dressing station was thirteen miles from the 
front line, and the Chouy main dressing station five and a 
half miles. 

The 15th Division had its first main dressing station at 
Coeuvres-et-Valsury, but did not then form an advanced 
dressing station, the wounded being evacuated to the main 
dressing station direct through loading posts in the Chazelle- 
Chaudun Valley and at Chaudun. When the division moved to 
Villemontoire area an advanced dressing station was formed 

Sketch map showing positions of medical posts or the I5 t . h &54 t " British 
Divisions with the Foench Groupe d'Armees de Reserve on the Western 

FLANK OF THE MaRNE SALIENT DURING OPERATIONS OF JULY 1918- 




at Lechelle. The distance of the main dressing station of the 
15th Division from the casualty clearing station was thirty-one 
miles and from the front line about seven miles. 

The position of No. 63 CCS. at Senlis was undoubtedly 
much too far back, but as the building was ready and the 
casualty clearing station was required to take in wounded 
within six hours of its arrival, no alternative site was 
feasible at the time. 

Permission was obtained from the French authorities to 
pitch tents and bring up ambulance trains to Villers Cotterets, 
and an application was made by wire on 29th July for a second 
casualty clearing station to be pitched under canvas at Halte 
St. Remy on the site of the existing walking wounded post. 



MEDICAL SERVICES WITH THE FRENCH 289 



Sick and Wounded admitted to C.C.S., Evacuated to Base, or 
Died during the Operations of the 15th and 34th Divisions 
on the Marne, from 6 a.m. 23rd July to 6 a.m. 5th August 
1918. 







Admitted. 


Evacuated. 


Died 
of 


For twenty-four 














hours ending 


Sick. 


Wounded. 


Sick. 


Woi 


nded. 




6 a.m. 


















Off. 


O.R. 


Off. 


O.R. 


Off. 


O.R. 


Off. 


O.R. 


Off. 


O.R. 


July 24th . . 


1 


76 


34 


573 


















„ 25th. 




3 


34 


11 


650 


3 


39 


42 


855 






„ 26th. 




— 


— 


6 


213 


1 


68 


4 


333 






„ 27th. 




3 


21 


16 


427 


2 


22 


19 


467 






„ 28th. 




2 


94 


10 


176 


. — 


— 


— 


— 






„ 29th. 




— 


21 


14 


282 


2 


104 


13 


309 






„ 30th. 




1 


61 


25 


624 


2 


72 


22 


749 






„ 31st . 




1 


110 


24 


1,017 


— 


99 


25 


853 






Aug. 1st . 




3 


49 


6 


220 


1 


24 


6 


350 






„ 2nd . 




— 


41 


31 


405 


2 


61 


13 


317 






, 3rd . 




1 


24 


10 


778 


1 


40 


28 


852 






,, 4th . 




1 


59 


13 


208 


— 


— 


— 


— 






„ 5th . 




— 


9 


2 


12 


2 


43 


15 


331 






Totals 


16 


599 


202 


5,585 


16 


572 


187 


5,416 


10 


94 


Total, 15th Div. .. 


8 


316 


115 


2,457 


8 


298 


J03 


2,364 


6 


50 


Total, 34th Div. .. 


8 


283 


81 


3,061 


8 


274 


78 


2,985 


4 


44 


Americans 


— 


— 


6 


18 


— 


— 


6 


18 


— 


— 


Germans 


— 


— 


— 


49 


— 


— 


— 


49 


— 


— 



Number and Disposal of British Sick and Wounded of 15th and 
34th Divisions admitted to Allied Medical Units. 



Units. 


Total 
Number. 


To 
CCS. 


To 
Interior. 


Returned 
to Duty. 


Died. 


Remaining 
in Army 
Area unfit 
for Evacua- 
tion. 


American . . 
French 


133 
170 


125 

93 


47 


7 


8 

16 


7 


Totals . . | 303 


218 


47 


7 


24 


7 



290 MEDICAL HISTORY OF THE WAR 

In view, however, of the early withdrawal of the British 
divisions this casualty clearing station was withheld. The 
alternative of sending part of No. 63 CCS. to Halte St. Remy 
as an advanced operating centre was considered, but it was 
not thought practical owing to the high pressure at which 
it was working. Several cases of severety wounded men 
were taken instead to the French operating centre near Villers 
Cotterets. 

The relief of congestion at the casualty clearing station and 
at the main dressing stations was the main consideration. 
Consequently on three occasions, namely, July 29th, 30th and 
August 2nd, when large numbers had to be dealt with, the 
lightly wounded were sent down by ambulance train from the 
walking wounded post at Halte St. Remy. The trains halted 
at Senlis, and any patients who required immediate operation 
were removed to the casualty clearing station and the train 
loads adjusted. In this way 1,443 wounded were sent down 
from Halte St. Remy by ambulance train, and 1,240 of them 
went on to the base, without entering the casualty clearing 
station. Owing to this expedient there was never at any 
time congestion at the main dressing stations or at the casualty 
clearing station. 

The numbers of sick and wounded admitted and transferred 
to the base during the period are shown in the table on the 
preceding page. Most of those admitted to French or American 
medical units were transferred to No. 63 CCS. 

With the close of these operations the medical units were 
distributed to the armies on the British front. G.H.Q. (South) 
was closed on the 19th August, the last of the medical units, 
No. 63 C C.S., having left on the 14th of the month. 



CHAPTER XVII. 

THE MEDICAL SERVICES DURING THE ADVANCE TO VICTORY. 

THE period of offensive action by the British Armies, which 
led to final victory and the Armistice on the 1 1th November 
1918, has been divided into two phases ; the first a phase of 
fighting in entrenched positions, and the second a phase of 
fighting in open country.* The first phase was one in which 
the enemy was driven out of one position after another to the 
Hindenburg line between St. Quentin and the Scarpe, and 
culminated in the British forces breaking through the Hinden- 
burg line at the end of September and beginning of October 
1918. Consequently the operations of this phase took place 
in the devastated area over which the Battles of the Somme 
in 1916, of Arras in 1917 and of the German offensive in 1918 
had been fought. During the second phase the enemy was 
driven back fighting rearguard actions over open country 
until the British entered Maubeuge on the 9th and Mons on the 
11th November, when hostilities ceased. 

Outline of the Operations. 
The British offensive was commenced by the Fourth Army 
in front of Amiens, in combination with the French First 
Army. The Canadian Corps was on the right, the Australian 
Corps between it and the Somme, and the Illrd Corps on 
the left, north of the Somme, the Fourth Army front extending 
for some eleven miles from the Amiens-Rove road to Morlan- 
court. The French First Army was placed under Sir D. Haig's 
orders for the operations and was on the right of the Canadian 
Corps. The Cavalry Corps was behind the Fourth Army 
front east of Amiens. The attack, which was commenced 
on the 8th August with massed artillery fire, was completely 
successful, an advance of six or seven miles being made by 
nightfall. It was continued on the 9th August and following 
days, and was finally broken off on the 13th August after the 
front had been advanced to a line from Dernancourt through 
Bray and Proyart to the west of Chaulnes and Roye. The 
three cavalry divisions, fourteen infantry divisions, including 
the 33rd American Division, and 400 tanks took part in these 
operations. 

* Sir Douglas Haig's despatches, p. 257. 
10134 Z 



292 MEDICAL HISTORY OF THE WAR 

This opening battle was followed by minor operations in 
Flanders, including the capture of Oultersteene by the 31st, 
29th and 9th Divisions of the Second Army on the 18th and 
19th August. 

The next great attack was opened by the IVth and Vlth 
Corps of the Third Army on the 21st August. They attacked 
on a nine-mile front north of the Ancre from Hamel to 
Moyenneville, and advanced to the Albert-Arras railway 
before night. The following day the Illrd Corps attacked 
south of Albert and recaptured the town ; and then on the 
23rd August the main attack on the enemy's entrenched 
positions was launched along the whole front of some thirty- 
three miles from the junction ot the British with the French 
at Lihons, north-west of Chaulnes, to Mercatel, south of Arras. 
The Australian and Illrd Corps of the Fourth Army south 
and north of the Somme, and the IVth, Vth and Vlth Corps 
of the Third Army were engaged. The fighting was continued 
until the 1st September over the old battle ground of the Somme 
in 1916. The British line at the close of the operations had 
then been advanced to the Somme, south of Peronne, and 
northwards through Peronne and Bapaume to the Scarpe, east 
of Roeux. Twenty-three divisions had taken part in the 
battle and had captured over 34,000 prisoners and 270 guns. 
The enemy as a result of these operations had commenced to 
shorten his line on the Lys salient, with the result that by the 
2nd September the British front was advanced from Festubert 
to Estaires and northward to Steenwerck and Kemmel ; Merville 
and Bailleul were thus reoccupied although now reduced to ruins. 

In the meantime the Canadian Corps, which had handed 
over its area on the right of the Fourth Army to French troops 
and had moved up to the right of the First Army, attacked 
the German positions astride the Scarpe east of Arras on the 
26th August on a front of five and a half miles and captured 
Monchy-le-Preux. The First Army then continued to carry 
the German positions and by the end of the month had come 
within assaulting distance of the Hindenburg line from 
Quean t to Drocourt south-west of Lens. On the 2nd Sep- 
tember this line was attacked and broken by the XVIIth 
Corps of the Third Army and the Canadian Corps of the First 
Army, 8,000 prisoners being taken. In all 16,000 prisoners 
had been captured during the battle of the Scarpe. Ten 
divisions were engaged in the battle. 

The next stage in the advance consisted of operations 
against Havrincourt and Epehy between the 12th and 18th 



THE ADVANCE TO VICTORY 293 

September by corps of the Fourth and Third Armies. Both 
these positions, it will be remembered, were positions around 
which battles were fought in November and December 1917 
by the Third Army. The vicinity of these villages was held 
in strength covering the Hindenburg line. The Canal du 
Nord, north of Havrincourt, was also strongly held by the 
enemy. The positions in the Havrincourt sector were attacked 
on a front of about five miles by the IVth and Vlth Corps of 
the Third Army on the 12th September, and the villages of 
Trescault and Havrincourt occupied. Further south the 
IXth and Australian Corps pushed forward and captured 
Holnon village, at the junction of the British with the French 
line, by the 17th September. On the following day an attack 
was then made by the Fourth and 1 hird Armies on a seventeen- 
mile front between Holnon and Gouzeaucourt, in co-operation 
with the French south of Holnon. The fighting was very 
severe and took place in heavy rain. All the enemy's positions 
and nearly 12,000 prisoners were captured by nightfall. 
Fifteen divisions took part in these operations. 

The final and decisive operations against the German 
entrenched positions commenced on the 27th September and 
ended on the 5th October. On the first day the IVth and 
Vlth Corps of the Third Army and the XVI Ith and Canadian 
Corps of the First Army attacked on a front of some thirteen 
miles from Gouzeaucourt along the Canal du Nord to opposite 
Sauchy-Lestree. The main feature of the operation was the 
crossing of the canal in the neighbourhood of Moeuvres in 
the centre of the attack, when the troops debouched fan- 
wise north-west towards the Sensee Canal and southwards 
towards the St. Quentin Canal at Marcoing, while the centre 
pushed forward through Bourlon Wood in the direction of 
Cambrai. Fourteen divisions took part. The operations were 
completely successful, 10,000 prisoners were captured, and a 
line secured from Beaucamp, north of Gouzeaucourt, through 
Ribecourt, Fontaine-Notre-Dame to Epinoy and Oisy le 
Verger, south of the Sensee Canal, the depth of the advance 
at its centre being about four miles. 

This attack was followed on the 29th September by art 
attack delivered by the Fourth Army with the IXth, Ilnd 
American Corps, and Illrd Corps ; by the French First Army 
on its right, and by the Vth and IVth Corps of the Third 
Army between Vendhuille and Marcoing on its left. The 
attack was against the Hindenburg line and strongly defended 
positions east and west of the Scheldt Canal, between Holnon 



294 MEDICAL HISTORY OF THE WAR 

and Vendhuille. In one section, between Bellicourt and 
Vendhuille, the canal ran through a tunnel for some 6,000 
yards. The righting was general all along the line and in 
places against determined resistance ; but the Hindenburg 
line was broken through in several places and the enemy's 
rear defences taken, an advance being made to a depth of 
some three miles to beyond Magny-la-Fosse in the centre of 
the attack by the 46th Division, the troops of which had 
swum or waded across the canal north of Bellenglise. The 
two American divisions, the 30th and 27th, were heavily 
engaged between Bellicourt and Bony near the canal tunnel, 
with the 5th and 3rd Australian Divisions in support. 

The Third Army had in the meantime crossed the Scheldt 
Canal between Masnieres and the outskirts of Cambrai, and 
the line had been advanced still further by the Canadian 
Corps to the north-west of Cambrai. The fighting con- 
tinued during the following days until the whole of the 
Hindenburg line of defences had been broken through. St. 
Quentin was occupied by the French on the 1st October, and 
by the evening of the 7th October the British line ran due 
north from St. Quentin to Cambrai and thence westwards along 
the Sensee Canal to the old line north of Sauchy-Lestree. The 
thirty British and two American divisions engaged in these 
operations captured 36,000 prisoners and 360 guns 

While these battles were being fought in the south of the 
British front, a great advance was made in Flanders on the 
Ypres front by the Belgian Army, some French divisions, 
and the XlXth and Ilnd Corps of the Second Army, which 
had been placed under the command of the King of the 
Belgians for the operations. The XlXth and Ilnd Corps 
attacked on the 28th September on a four and a half mile front 
south of the Ypres-Zonnebeke road, the Belgians on their left 
carrying on the front as far as Dixmude. The enemy's 
resistance was slight, and the line by the evening of the 1st 
October had reached the Lys from Armentieres to Comines, 
and north of that town to a position west of Menin and east of 
Moorslede ; a depth of some eight or nine miles from the 
original position in front of Ypres. 

The British front from Lens to Armentieres was also 
advanced during this period to beyond Lens, La Bassee and 
Armentieres by the withdrawal of the enemy from his positions 
astride the La Bassee Canal. This front had been taken 
over by the reconstructed Fifth Army under General Sir W, 
Birdwood, the depth of the advance from the line held west 






THE ADVANCE TO VICTORY 295 

of Merville on 8th August being some twelve or thirteen miles 
to Erquinghem within five miles of Lille. 

The second phase of the advance to victory commenced 
on the 8th October with an advance in open country to 
Maubeuge and Mons by the Fourth and Third Armies and 
the right of the First Army. 

The first stage of this advance was against Le Cateau. 
The operations were opened on the morning of the 8th October 
by the Fourth and Third Armies on a front of over seventeen 
miles from Sequehart, at the junction of the British right 
with the French First Army, to south of Cambrai. On the 
first day the line was advanced to near Cambrai. On the 
following night Cambrai was entered and by the night of the 
9th October the advance had reached to within two miles of 
Le Cateau, where it was held up on the 10th October along 
the west bank of the river Selle. Twenty British divisions, 
two British cavalry divisions and one American division 
took part in this advance, capturing 12,000 prisoners. The 
depth of the advance was some thirteen miles. While these 
operations were going on, the enemy, fighting rearguard actions, 
withdrew from the area between the Scarpe, Douai and Lens, 
and the 8th Division reached the outskirts of Douai on the 
13th October. A similar retreat was effected in front of the 
French, who occupied Laon on the 13th October. 

On the north the force under the King of the Belgians 
attacked along the whole front from the Lys at Comines 
to Dixmude. The British sector of the force extended from 
Comines to St. Pieter, half way between Menin and Roulers. 
The Xth, XlXth and Ilnd Corps were engaged, with the 
30th and 34th, 41st and 35th, and the 36th, 29th and 9th 
Divisions respectively. There was considerable opposition, 
but by the 16th October the British line was advanced to 
beyond Menin as far as Courtrai, while the French and Belgian 
troops further north had occupied Roulers and Thourout. 
" Ostend fell on the 17th October and three days later the 
northern flank of the Allied line rested on the Dutch frontier."* 
Further south a movement towards Lille was commenced 
by the VHIth Corps of the First Army, the Xlth Corps of the 
Fifth Army, and XVth Corps of the Second Army. By the 
evening of the 17th October Lille was entered, and the advance 
was carried steadily eastwards until, on the evening of the 22nd 
October, the general line of the Scheldt was reached from the 

* Sir Douglas Haig's despatches, p. 290. 



296 MEDICAL HISTORY OF THE WAR 

western outskirts of Valenciennes and Tournai to some seven 
miles east of Courtrai. This advance was a specially rapid 
one extending as it did to a depth of some twenty miles between 
the 17th and 22nd October. 

While this advance was being made on the north, much severe 
fighting was taking place on the Fourth Army front for about 
ten miles from Le Cateau southwards. The IXth, Ilnd 
American and Xlllth Corps attacked the enemy in that 
sector on the 17th October in conjunction with the French 
First Army west of the Sambre and Oise Canal opposite Guise. 
The enemy offered a strong resistance, but by the 19th October 
he was driven across the Sambre and Oise Canal. This was 
followed by an attack on the line of the Selle, north of Le Cateau, 
on the 20th October by seven divisions of the Third Army 
and one of the First Army. Again there was determined 
resistance with frequent counter-attacks. On the 23rd October 
a fresh attack was made, at first by the IXth and Xlllth Corps 
of the Fourth Army, followed by the Vth, IVth, Vlth and 
XVIIth Corps of the Third Army along a fifteen-mile front 
from the junction with the French, facing the Sambre, to the 
north-east of Haussy. The next day the attack was extended 
five miles northwards by the left of the XVIIth Corps and 
XXIInd Corps of the First Army to the Scheldt, south-west 
of Valenciennes. In spite of unfavourable weather, difficult 
country and determined opposition, the British line was 
advanced to a depth of six miles and ran along the Sambre 
and the western outskirts of the Forest of Mormal to the 
vicinity of Le Quesnoy. Twenty-four British and two 
American divisions took part in this battle and captured 
20,000 prisoners and 475 guns. 

The final battle of the war on the Western Front was now 
opened with the capture of Valenciennes after two days' fighting 
on the 1st and 2nd November by the XVIIth Corps of the 
Third Army and the XXIInd and Canadian Corps of the 
First Army on a front of some six miles south of the town. 
Following on this the main and decisive attack was made on 
the 4th November by the Fourth, Third and First Armies on 
a front of some thirty miles from the Sambre, north of Oisy to 
Valenciennes. The attack was carried forward across the 
river and through the Mormal Forest by twenty-six divisions 
of the IXth, Xlllth, Vth, IVth, Vlth, XVIIth, XXIInd, and 
the Canadian Corps. 19,000 prisoners were captured. On the 
night of the 4th/5th November the enemy began to fall back 
on his whole front. After that time the resistance was weak. 



SKETCH MAP SHOWING THE MOVEMENTS OF CASUALTY CLEARING STATIONS DURING THE ADVANCE TO VICTORY. 



Watte* ro1°" S 



^% I 
Esouelbccg. £% B ^jg „ 



c^Mxtt^-s^ ",^_ 



a n 



&*+ f p a n c o - Bel n ; 

landagham-'",, ' 



.&S'Hallu 



/ Ate,/,?., .J*"*. .,\ "% a«So — f-^^Kmmel. 











I 















^Doulleos. 



- ; ? s J xfesCorps- VeoquemonC "^Si. 



.-/V G 7/ / / . ■■-.- \Vf A <^ \ / ^^T* To art/7 \ //( 



|.>' , &'. ^~~»<3V-&Jo/M».«f 3 fl,„.---* few,','*, 

■^^^ni^pT&SfijSfea^ 



H"t8CCSfro„Lj>r~C.t. 




,„„,,»"'"""" 



i\ / 





■ w 



A CCS. Positions on November II 01 1918. 

w C.CS's. brought up from L.ofC. 
^n Stationary Hospitals at commencement of attack. 

A Final position of Stationery Hospitals which mo</ed 

<$ prior to November ll<* 1918. 
.-- British Front Line et the beginning of the Advance. 
«■■ ...Do. 0o.--.0o. at the time of the Armistice. 

Intermediate positions of the British Line during the Advance. 

|j5 ap Miles. 



THE ADVANCE TO VICTORY 297 

The advance was then rapid. Maubeuge was entered on the 
9th November by the Guards and the 62nd Division, and Mons 
on the 11th November by the 3rd Canadian Division after 
considerable opposition. 

At 11 a.m. on that day hostilities ceased. 

The Medical Services with the Fourth Army. 
The Battle of Amiens. — The preparations for the opening battle 
on the 8th August by the Fourth Army were kept very secret. 
In order to divert attention from the direction of the attack 
some Canadian units and No. 1 and No. 4 Canadian C.C.Ss. 
were transferred to Arneke in the Second Army area from 
Pernes during the previous week, and no medical units were 
permitted to be moved into the Fourth Army area before the 
commencement of the attack. The Canadian Corps was then 
being transferred to the Fourth Army from the First Army. 
The D.M.S. of the Fourth Army, Maj. -General M. O'Keeffe, 
was informed of the impending operations on the 6th August, 
and at once applied to the D.G.M.S. for two more casualty 
clearing stations, three motor ambulance convoys, fourteen 
surgical teams and forty-eight extra nursing sisters. He 
cleared all sick from casualty clearing stations to the base on 
the 7th August, and ordered Nos. 53, 55 and 49 C.C.Ss. to 
close' down and be ready to move suddenly with twelve lorry 
loads of stores each. Over 4,000 sick were thus unloaded on 
to base hospitals on the 6th and 7th August, a proceeding 
which in itself was apt to indicate where the attack was likely 
to take place, but too late for the enemy to take advantage 
of any information so obtained, The Asylum just south of 
Amiens on the Amiens-Dury road was marked down as a 
suitable position to which the casualty clearing stations could 
be brought forward. No. 48 CCS. was then on its way from 
the French zone and was diverted to that locality. 

The Fourth Army had twelve casualty clearing stations on 
the 6th August placed as follows : — 

Crouy . . . . Nos. 5 and 47. 

Longpre . . Nos. 12, 53 and 55. 

Pernois . . Nos. 4 and 41. 

St. Riquier . . No. 49 and Lucknow. 

Vignacourt . . Nos. 20, 61 and 37. 
No. 41 Stationary Hospital was at Pont Remy. 
The sketch map shows these positions. They were all 
further back than had been usual in consequence of the ex- 
periences during the German offensive earlier in the year. 



298 MEDICAL HISTORY OF THE WAR 

Consequently, only those at Pernois, Vignacourt and Crouy 
were allotted for receiving wounded from the front line, those 
at Pernois for the Ilnd Corps, those at Vignacourt for the 
Australian Corps, and those at Crouy for the Canadian and 
Cavalry Corps. The others were for the sick of back areas 
and special cases. 

Advanced depots of medical stores were at Vignacourt 
(No. 13), Crouy (No. 14) and Longpre (No. 18). The motor 
ambulance convoys with the Army were Nos. 3 and 11 allotted 
to the Australian Corps, No. 10 to the Illrd Corps, Nos. 37 
and 44 to the Canadian Corps, Nos. 24 and 42 as Army 
Reserve. Some of the cars, however, of convoys No. 37 and 
No. 44, which had arrived just before the battle com- 
menced, had difficulty in getting up to the Canadian Corps 
to which they were allotted owing to congestion of traffic 
on the roads. 

No. 48 CCS. on its way from the French zone arrived at 
the asylum during the afternoon of the 8th August. The 
asylum was the main dressing station of the Canadian Corps 
at the time, and when the main dressing station was moved 
forward, the wounded, some 500, left there were taken over 
by No. 48 CCS. 

There was some difficulty with regard to the supply of 
surgical material to units of the Canadian Corps. They had 
arrived without any surgical dressings and had to be hurriedly 
supplied from the advanced depots. Lorries were sent to 
Abbeville to replenish the depleted advanced depots, as 
stores already requisitioned were being held up by congestion 
of traffic on the railway. 

Most of the surgical work during the 8th August fell on the 
casualty clearing stations at Crouy, but at dawn next day 
Nos. 55 and 53 were sent forward to Vecquemont and No. 49 
to Boves, both positions being in advance of Amiens and 
north and south respectively of the Somme. On the 10th 
August No. 47 CCS. was closed and moved to the asylum, 
and on the following day No. 61 CCS. was sent to Vecquemont. 
No. 1 and No. 4 Canadian C.C.Ss. were now coming down 
from the Second Army and were being placed at Boves. On 
the 13th August No. 37 CCS., which had been refitted on a 
mobilization scale after capture on the Aisne, was sent up to 
the Fourth Army and detrained at Vecquemont. On the 14th 
August No. 5 was closed at Crouy preparatory to going to 
Vecquemont on the 21st August, and on the 17th August 
No. 41 was also closed and sent to Vecquemont. 



THE ADVANCE TO VICTORY 



299 



Between 6 a.m. on the 8th August and 6 a.m. on the 11th 
August, the number of wounded received into the casualty 
clearing stations of the Fourth Army was as follows : — 





Offs. 


O.R. 


Germans. 




Offs. 


O.R. 


8th-9th August 19 18.. 
9th-10th 
lOth-llth „ 


353 
245 
183 


6,597 
3,974 
4,236 


17 

43 

22 


676 
814 
342 


Totals 


781 


14,807 


82 


1,832 



The numbers consequently were considerably less than in 
the first days of the great battles of 1915, 1916 and 1917, 
but the difficulty of handling them was probably greater, as 
the advance into the enemy's lines was to a depth of some 
nine or ten miles and casualty clearing stations had not yet 
been fully opened in the more forward areas. The situation 
was met by the number of convoys in the Fourth Army having 
been increased to admit of two being held in Army reserve, 
and of two being allotted to the Canadian and Australian 
Corps in place of the usual one. 

The casualties amongst medical personnel during these 
three days were four R.A.M.C., two C.A.M.C, one A.A.M.C. 
and four U.S.A. medical officers killed and six wounded, 
seventeen other ranks killed and sixty wounded. 

As many as forty-eight surgical teams from the lines of 
communication and other armies and sixty-four additional 
nursing sisters were sent to the casualty clearing stations of 
the Fourth Army between the 7th and 10th August. Until 
the casualty clearing stations that were being moved forward 
to the asylum, Boves and Vecquemont were ready, the 
six casualty clearing stations at Pernois, Crouy and Vignacourt 
had most of the work thrown on them. 

As this was the first experience during the war of an advance 
to a great depth necessitating a corresponding advance of the 
unwieldy casualty clearing stations, the following note of the 
20th August by the D.M.S. of the Army is of importance : 

" Most of the casualty clearing stations which have moved up to date 
have moved rapidly and at short notice. At first an attempt was made to 
move casualty clearing stations with twelve lorry loads. The amount of 
materials, etc., which they could carry on these loads was very limited and 
quite insufficient to deal with casualties coming in from a big battle. This 
was stopped and forty lorry loads were allowed. Frequently twenty lorries 



300 MEDICAL HISTORY OF THE WAR 

only were available, and they had to make two journeys in one day ; this 
is quite satisfactory provided the distance moved forward is not too great 

It is possible for a casualty clearing station with forty lorry 

loads to close, pack, re-pitch and open in a new place in thirty-six to forty- 
eight hours, which means that they carry as essentials all their canvas, Soyer's 
stoves for cooking, stretchers, blankets, and fifty beds and mattresses, and 
whatever else the O.C. likes to take to bring the total up to forty loads." 

This then was in marked contrast to the 100 to 200 lorry- 
loads, which had been moving casualty clearing stations in 
1916 and 1917, and forms an important basis for estimating 
the requirements of moving casualty clearing stations by road. 

It will be observed that at the end of the first stage of the 
great advance, the Fourth Army situation as regards the 
position of its casualty, clearing stations had materially altered. 
Vecquemont had become the chief centre, for six casualty 
clearing stations had been concentrated there ; not, however, 
on the old sites of the Somme battles but on high ground to 
the west of the town, about half a mileirom the railway station. 

Difficulty had been experienced in getting ambulance 
trains up to the new railheads during the operations, as directly 
a railhead was opened ammunition and supply trains came 
up in a constant stream. It was on account of this difficulty 
that so many casualty clearing stations were opened at Vecque- 
mont, as it was possible there to load two ambulance trains 
at one time, and the pressure of ammunition and supply trains 
was over by the time the casualty clearing stations had opened. 

No. 18 Advanced Depot of Medical Stores had moved to 
the asylum, south of Amiens, but otherwise there was no 
change in the position of advanced depots or of motor 
ambulance convoys during the advance. 

The divisions engaged during this first battle were the 3rd, 
1st and 2nd Canadian Divisions, between the Amiens-Roye 
and Amiens-Peronne road, with the 4th Canadian Division 
and the 3rd, 2nd and 1st Cavalry Divisions passing through ; 
the 2nd and 3rd Australian Divisions, between the Amiens- 
Peronne road and the Somme, with the 4th and 5th Australian 
Divisions passing through ; and the 50th, 18th and 12th 
Divisions of the Illrd Corps, between the Somme and the 
Ancre. The 32nd Division joined the Canadian Corps on the 
10th August and went into the line. 

The Canadian Corps divisions formed collecting posts, marked 
by a stick and white bandage, instead of regimental aid 
posts ; the bearers or horsed ambulance wagons brought the 
wounded who were collected by the regiments from these 
posts to the advanced dressing stations. The main dressing 



THE ADVANCE TO VICTORY 301 

stations, as the advance progressed, moved to the advanced 
dressing station positions. No attempt was made to pitch 
tents or occupy buildings. The weather was fine and the 
work of the main dressing station, except on the first day, 
could then be carried out in open fields. 

The Australian Corps had much fewer casualties than was 
anticipated. The D.D.M.S., Colonel Barber, in anticipation 
of much larger numbers of wounded, had organized a system 
of reserve dressing stations which were to open at specified 
points only when ordered to do so by him. His general 
arrangements after the advance in the afternoon of 10th 
August were to have two main dressing stations, one for the 
right and one for the left sector, each receiving casualties from 
an advanced dressing station and a divisional collecting post. 
A reserve dressing station was ready to open in each sector as 
required. There was a light railway between Vecquemont 
and Vignacourt and arrangements were made to run trains 
of ten trucks, each truck carrying fifteen to twenty lightly 
wounded, to the casualty clearing stations at Vignacourt. 

A feature in the work of the Australian Corps was the 
organization of blood transfusion and resuscitation teams for 
work with the field ambulances at the advanced dressing 
stations or main dressing station of each division. Until 
these were ready, a corps resuscitation team carried on the 
work of blood transfusion in suitable cases. Each team 
consisted of two officers and four orderlies, specially trained 
in the operation. 

The divisions of the Illrd Corps, which included the 33rd 
American Division, had main dressing stations at Querrieu, 
Montigny and Vadencourt, with a corps walking wounded 
collecting station at Montigny, for the operations on the 
8th August. They were cleared to the casualty clearing 
stations at Pernois. Twenty-eight lorries were placed at the 
disposal of the D.D.M.S., Colonel Profeit, for sitting cases. 
Four divisions were in the line when the attack was made, 
the medical situation being as follows : — 

Right division (58th) A.D.S. — Smith's Farm, near Querrieu. 

W.W.C. Post — Corbie-Mericourt Road, on 
the site of the Heilly C.C.Ss. during the 
Somme battles of 1916. 
M.D.S. — Querrieu. 
C.W.W. Station — Montigny Farm. 
Right centre (18th) A.D.S. — Bray-Corbie Road, about 1£ miles 

division. from Corbie. 

W.W.C. Post — As for right division. 

M.D.S. 

C.W.W. Station 



302 MEDICAL HISTORY OF THE WAR 

Left centre (12th) A.D.S.— Buire. 

division. W.W.C. Post — Sugar Factory, Ribemont. 

M.D.S. — Red Chateau, Montigny. 
C.W.W. Station — As for right division. 

Left division. (47th) A.D.S. — Henencourt Chateau. 

W.W.C. Post— Warloy. 
M.D.S. — Vadencourt Chateau. 
C.W.W. Station — As for right division. 

The 66th American Brigade was with the 12th Division, 
but had its main dressing station with the 47th Division, and 
an independent advanced dressing station and walking wounded 
collecting post on the Querrieu- Albert road, the former just 
south-east of and the latter south-west of Bresle. The 63rd 
and 17th Divisions joined the corps during the operations * 

The wounded in the Illrd Corps from 6 a.m. 8th to 6 a.m. 
12th August were 190 officers and 3,927 other ranks, of whom 
35 per cent, were lying cases, 20 per cent, sitting and 45 per 
cent, walking cases. The average time for the return journey 
of cars from the main dressing stations to casualty clearing 
stations was three hours, and for lorries from the corps walking 
wounded stations to casualty clearing stations six hours. 

The Battles of the Somme.- — The operations of 21st August 
to 3rd September 1918, over the old battle ground of the Somme 
and Arras, had no specially new features so far as the medical 
situation was concerned, except in their effect on the strategical 
positions of the casualty clearing stations. As in the Somme 
battles of 1916, corps were constantly changing from one 
sector of the front to another and divisions from one corps to 
another. Their medical units were consequently subjected to 
the same frequent changes, and were employed in accordance 
with the general principle of main dressing stations following- 
up the advance to advanced dressing station positions and the 
latter to regimental aid post positions. 

The 1 1 ltd Corps of the Fourth Army received into its medical 
units during this period 325 officers and 7,569 other ranks, 
of whom 60 per cent, were walking wounded, 30 per cent, 
lying down cases and 10 per cent, sitting cases. During the 
first twenty-four hours, the average number of casualties in 
each division engaged was 800, the proportion of walking 
cases being higher, 69 per cent., than during the whole period. 
Colonel Profeit, the Corps D.D.M.S., records some interesting 



* His Majesty the King, on the 12th August, visited the dressing stations at 
Montigny and Querrieu. 



THE ADVANCE TO VICTORY 303 

and valuable details regarding the clearing of wounded back, 
during this period of mobile warfare :■ — 

" Except during an exceptional rush of casualties one car of the motor 
ambulance convoy every ten minutes at each divisional main dressing station 
and one lorry every twenty minutes at each divisional walking wounded 
collecting post were sufficient to keep clear. The speed of the lorries was 
about six miles per hour and of the cars seven miles per hour " 

The estimate of the number of motor ambulance cars 
and lorries required was based on these factors and on the 
distances between respective medical posts. 

The Fourth Army casualty clearing stations receiving the 
wounded were the six at Vecquemont No. 47 and No. 48 at 
the asylum, Amiens, and No. 49 and Nos. 1 (Canadian) and 4 
(Canadian) at Boves were not specially involved, as the opera- 
tions were chiefly north of the Summe, but they received a 
number of the walking wounded. There was some anxiety 
regarding evacuation from Vecquemont on account of delays 
in getting ambulance trains up, but in consequence of the 
large number of casualty clearing stations there, there was no 
great congestion. 

By the end of August further movements of the Fourth 
Army casualty clearing stations became possible, but owing 
to the Third and First Armies being engaged during this period 
as well as the Fourth, and to the area previously occupied by 
the Canadian Corps having been taken over by the French, 
the three casualty clearing stations at Boves were transferred, 
No. 49 to the Third Army to Colincamps, and the two Canadian 
casualty clearing stations to Pernes in the First Army. No. 4 
C.C.S., at Pernois, was also transferred to Colincamps. The 
Fourth Army casualty clearing stations were then distributed 
as follows by the end of the month. Their new positions 
indicate the substantial advance made during the battle : — 

Edgehill . . Nos. 47 and 48 from the asylum 
and No. 55 from Vecquemont. 
Heilly . . No. 20 from Vignacourt. 

Proyart . . Nos. 5 and 41 from Vecquemont. 

Vecquemont . . Nos. 53, 37 and 61. 
Longpre . . No. 12. 

No. 41 Stationary Hospital was moved then into the asylum, 
at Amiens, from Pont Remy. 

Between the 2nd and 18th September the Fourth Army was 
not heavily engaged, but during that period a steady advance 
was made over ground from which the enemy had withdrawn, 

(10134) Z* 



304 



MEDICAL HISTORY OF THE WAR 



and the casualty clearing stations were moved to positions 
still further forward. Vecquemont was closed as a casualty 
clearing station centre by the 9th September. No. 53 moved 
to Peronne la Chapellette, where it was joined by No. 12, 
from Longpre, on the 9th September ; No. 37 and No. 61 
went to Maricourt Plateau. Edgehill was also closed ; No. 48 
CCS. moving on the 12th, and No. 47 on the 16th September 
to Brie, south of Peronne and on the east bank of the canal, 
and No. 55 on the latter date to Doingt, where No. 20, from 
Heilly, had already arrived ; so that before the operations, 




No. 118 U.S.A. Field Ambulance at Tincourt during the 
Advance to Victory, 1918. 



which commenced on the 18th September, the Fourth Army 
casualty clearing stations were all at Proyart, Peronne la 
Chapellette, Doingt, Brie or Maricourt Plateau. 

The Battle of Epehy. — On the 18th September the Fourth 
Army again attacked with the Illrd and IXth Corps, and a 
further advance was made ; the wounded admitted to the 
casualty clearing stations of the army between the 18th and 
21st September being 345 officers, 8,359 other ranks, 24 German 
officers and 757 German other ranks. The wounded during this 
attack were received into the casualty clearing stations at 
Brie, Peronne la Chapellette and Doingt. After the fighting 
had ceased Proyart was closed as a casualty clearing station 
centre, No. 41 CCS. moved to Doingt and No. 5 to Brie. 



THE ADVANCE TO VICTORY 305 

The casualty clearing stations, Nos. 12 and 53, at Peronne 
la Chapellette, on the west of the canal, were also moved 
forward to Tincourt, to the old casualty clearing station site 
there. Tincourt was also reinforced by two other casualty 
clearing stations, Nos. 50 and 58, the former from the L. of C. 
and the latter from the Second Army ; so that when the Fourth 
Army made its assault on the Hindenburg line on the 29th 
September, there were four casualty clearing stations at 
Tincourt, three at Brie, three at Doingt, and two on the 
Maricourt Plateau. 

The Battle of St. Quentin Canal. — The attack on the 29th 
September by the Fourth Army was made by the Illrd (12th 
and 18th Divisions), Hnd American (37th and 30th Divisions), 
Australian (1st, 2nd, 3rd, 4th and 5th Australian Divisions) 
and IXth Corps (1st, 6th, 32nd and 46th Divisions), with the 
XHIth Corps and Cavalry Corps in support. The distance 
of the casualty clearing stations from the front line of attack 
was from ten to fourteen miles, Tincourt being the nearest 
centre. During the interval between the 21st and 29th 
September there had been no operations on a large scale, 
although fierce fighting took place at many points of the line 
occupied by the Fourth and Third Armies between St. Quentin 
and Cambrai. The general assault on the Hindenburg line 
in the Fourth Army sector led to stubborn fighting north of 
St. Quentin, which continued for several days. The number 
of wounded who were admitted to its medical units between 
the 29th September and 5th October amounted to 743 officers, 
16,863 other ranks, and 50 German officers and 1,262 German 
other ranks. 

The Battle of Cambrai. — A further advance of casualty 
clearing stations of the Fourth Army was now made previous 
to a renewal of the attack on the 8th October. Sites for 
them had been selected at Bihecourt, on the St. Quentin- 
Roisel line of railway, about one mile north of Vermand, and 
at Roisel, about three miles east of Tincourt. Nos. 41, 48 
and 53 C.C.Ss. were moved to Roisel, and Nos. 5, 47 and 61 
to Bihecourt by the 7th October. These formed then the 
forward casualty clearing stations with three still at Tincourt, 
two at Doingt and one at Maricourt Plateau. Brie ceased to 
be a casualty clearing station centre. The railway sidings, 
however, at Roisel and Bihecourt were not ready on the day 
of the renewed attack, and the casualty clearing stations 
there were not opened for wounded on the 8th October. Trains 
came up to these places for the first time on the 10th October. 



306 MEDICAL HISTORY OF THE WAR 

Between the 6th and 12th October the wounded in the Fourth 
Army numbered 304 officers, 7,275 other ranks, 22 German 
officers and 782 German other ranks. 

Battles of the Selle and Sambre. — The next general attack, 
in which the Fourth Army was engaged, took place on the 
17th October by divisions of the XHIth, Hnd American and 
IXth Corps. The most forward railheads for ambulance 
trains at the time were Bihecourt and Roisel. The fighting 
in open country had now commenced and although the number 
of wounded in the Fourth Army then became less as compared 
with the previous fighting — numbering some 3,000 to 4,000 
weekly until the Armistice — the difficulties of transport were 
greater, owing to the rapid advance, the broken nature of 
railways and roads in the devastated areas, and the damage 
done to them by the retreating enemy. 

Between the 17th October and the date of the Armistice 
only two more advanced casualty clearing station positions 
were opened by the Fourth Army, namely, at Bohain and 
Busigny. Nos. 55, 20, 50 and 61 C.C.Ss. went to the former 
place between the 19th and 22nd October ; and Nos. 12 and 
48 to the latter on the 22nd and 23rd October. Doingt thus 
ceased to be a casualty clearing station centre during the last 
week of October, and Tincourt was reduced to one casualty 
clearing station only, No. 58. Maricourt was vacated on the 
2nd November by No. 37 CCS. being moved up to Busigny. 

The situation, therefore, of the casualty clearing stations 
in the Fourth Army at the time of the Armistice was as 
follows : — 

At Bohain . . Nos. 20, 50, 55 and 61. 

„ Busigny . . Nos. 12, 48 and 37. 

,, Bihecourt Nos. 5 and 47. 

„ Roisel . . Nos. 41 and 53. 

,, Tincourt . . No. 58. 

No. 41 Stationary Hospital remained at the asylum, Amiens, 
throughout the advance. 



Medical Services with the Third Army. 

The Third Army became engaged in the active operations 
of the advance on the 21st August, after the Fourth Army had 
advanced the front to a line from Lihons to Albert. The 



THE ADVANCE TO VICTORY 



307 



Fienvillers 

Gezaincourt . . 

Frevent 

W a vans 

Ligny-sur-Canche 

Fillievres 

Hesdin 

Auchy-les-Hesdin 



casualty clearing stations of the Third Army were then situated 
in the following localities : — 

Nos. 34 and 38. 

Nos. 3, 29 and 56. 

Nos. 19 and 43. 

No. 21. 

No. 3 Canadian. 

No. 46. 

No. 59. 

No. 45. 

The two stationary hospitals, No. 6 at Frevent and No. 3 
(Canadian) at Doullens Citadel, had been moved before the 
attack. The former was at Fillievres, where it was ready 
to receive patients on the 18th August. The latter had been 
closed on the 11th August and was at Rouen. 

The Battles of A Ibert and Bapaume. — In the fighting which 
took place on the Third Army front from Hamel, on the Ancre, 
to Moyenneville, between the 21st and 24th August, 529 officers 
and 12,746 other ranks, and 38 German officers and 980 German 
other ranks were admitted to the Third Army casualty clearing 
stations, chiefly to those at Gezaincourt and Frevent. An 
advanced operating centre was formed at the main dressing 
station of the Vlth Corps at Bac-du-Sud with a surgical team 
from No. 46 CCS. In the subsequent fighting 603 officers 
and 15,563 other ranks and 45 German officers and 923 German 
other ranks were admitted to the Third Army C.C.Ss. 
between the 25th and 31st August. 

The line had then advanced to beyond Bapaume, and casualty 
clearing stations began to move forward. Nos. 45 and 46 
were brought up on the 26th August to Bac-du-Sud 
(Bailleulval) ; Nos. 4 and 49 from the Fourth Army to Colin- 
camps on the 28th and 29th August ; and No. 59 and No. 3 
(Canadian) to Varennes at the same time. 

The Battle of the Hindenburg Line. — During the fighting 
on the Third Army front in September and until the commence- 
ment of open fighting the wounded, during periods of attack, 
were as follows : — 





Offs. 


O.R. 


Germans. 




Offs. 


O.R. 


Sept. 1st to 7th 
Sept. 18th to 21st 
Sept. 21st to 28th .. 
Sept. 29th to Oct. 5th 


390 
214 
355 
306 


8,538 
5,130 
9,155 
7,289 


22 

6 

31 

17 


907 
223 
840 
389 



•308 



MEDICAL HISTORY OF THE WAR 



The situation of the casualty clearing stations during these 
periods was : — 





Forward Area. 


Middle Area. 


Back Area. 


For Sept. 1st to 7th 


Bac-du-Sud (2) 





Fienvillers (2). 




Varennes . . (2) 




Gezaincourt (2). 




Colincamps (2) 




Frevent .. (3). 
Wavans . . (1). 


For Sept. 18th to 21st 


Beaulencourt(2) 


Varennes . . (2) 


GSzainconrt (1). 




Grevillers . . (2) 


Bac-du-Sud (2) 


Wavans . . (1). 




Boisleux-au- 


Colincamps (2) 






Mont (2) 






For Sept. 22nd to 


Beaulencourt(3) 


Varennes . . (2) 


Gezaincourt (1). 


30th. 


Grevillers . . (3) 
Boisleux-au- 

Mont (2) 
Delsaux Farm(l) 


Bac-du-Sud (2) 





The Final Advance. — Before the Third Army was engaged 
on the 8th October and subsequent days in the fighting in 
open country, Ytres had been reoccupied as a casualty 
clearing station centre. No. 3 (Canadian) came there on the 
1st October and No. 18 C C.S. three days later. A second 
casualty clearing station (No. 46) was also brought up on the 
1st October to Delsaux Farm, south of Beugny, on the Cambrai 
road, about five miles east of Bapaume. Consequently, 
during the fighting between the 8th and 14th October, which 
advanced the Third Army front to Le Cateau over a depth of 
some twelve miles, the most forward of the casualty clearing 
stations were at Ytres and Delsaux Farm. Ytres was about 
twelve miles from the front line on October 7th and twenty- 
four miles on October 14th. The remaining casualty clear- 
ing stations at Beaulencourt, Grevillers, Boisleux-au-Mont, 
Varennes and Gezaincourt were ten to thirty miles still further 
back. 

The Third Army was again engaged in severe fighting on 
the 20th, 23rd and 24th October, pushing its advance on to 
Le Quesnoy, some seven miles further, just before this 
attack took place, No. 59 CCS. from Varennes and No. 45 from 
Bac-du-Sud were moved to a forward position at Awoingt, 
south of Cambrai. From Boisleux-au-Mont No. 38 CCS. was 
also moved to Awoingt on the 20th October, and on the 23rd 
October No. 19 CCS. was brought up to Caudry, where good 
buildings were available, half-way between Cambrai and Le 
Cateau. 



THE ADVANCE TO VICTORY 



309 



Between the 24th October and the 4th November, when the 
operations commenced in the country between Valenciennes 
and the Sambre, the number of casualty clearing stations at 
Caudry was increased to four by the arrival of No 21 from 
Gezaincourt on the 26th October, No. 3 from Beaulencourt on 
the 31st October, and No. 49 from Grevillers on the 3rd Novem- 
ber. Two casualty clearing stations, No. 4 from Beaulencourt 
and No. 34 from Grevillers, were opened at Solesmes in a much 
more advanced position during the first three days of November. 




No. 3 New Zealand Field Ambulance at Solesmes, 1918. 

The number of wounded received into the Third Army 
casualty clearing stations during the fighting between the 
6th October and 2nd November was as follows : — 





Offs. 


O.R. 


Germans. 




Offs. O.R. 


Oct. 6th to 12th 
Oct. 13th to 19th 
Oct. 20th to 26th 
Oct. 27th to Nov. 2nd 


379 
103 
443 

98 


8,294 
2,947 
9,953 
2,247 


35 
2 

32 
9 


718 
67 

762 
97 



(10134) 



AA 



310 MEDICAL HISTORY OF THE WAR 

No ambulance trains could come up to Cambrai for the 
casualty clearing stations at Awoingt. Consequently, on the 
25th October wounded had to be carried from Awoingt by 
motor ambulance convoys to the casualty clearing stations at 
Ytres and Delsaux Farm, or to Beaulencourt and Grevillers, for 
evacuation by ambulance train. Evacuation in this way by 
road was particularly heavy, ten cars running hourly all day 
to Ytres and Delsaux Farm from Awoingt. 

On the 3rd November, on the eve of the final operations, 
the railway bridge at Caudry was blown up by a delay-action 
mine, and no ambulance trains could be run to the casualty 
clearing station there. A large number of buses was obtained, 
and some twenty were kept for road evacuation from Caudry 
to Awoingt and, if necessary, to Delsaux Farm and Ytres. 
There was thus considerable trouble in evacuating the casualties 
during the fighting of the 4th and 5th November. Ambulance 
trains, moreover, were not running well and the number 
arriving to clear Awoingt was too few. The buses, owing to 
blocks on the road, took much longer on their journeys than 
had been usual. Evacuation had consequently to be carried 
on continuously by ambulance cars to Ytres and Delsaux 
Farm, and by the evening of the 5th November the drivers 
were much exhausted. 

Owing to the rapidity of the advance between that date 
and the Armistice, the casualty clearing stations were left far 
behind, but the casualties, fortunately, were comparatively 
few. Third Army troops entered Maubeuge on the 9th 
November and then active operations ceased. 

The wounded of the Third Army between the 3rd and 9th 
November were 355 officers and 7,582 other ranks, and 47 
German officers and 958 German other ranks. The only 
change then made in the casualty clearing stations was to 
move No. 3 (Canadian) to Le Quesnoy on the 9th November, 
Consequently the situation of casualty clearing stations of 
the Third Army at the time of the Armistice was as follows : — 
At Solesmes . . . . Nos. 4 and 34. 

No. 3 (Canadian). 

Nos. 3, 19, 21 and 49 

Nos. 38, 45 and 59. 

Nos. 46 and 29. 

No. 18. 

No. 56. 



,, Le Quesnoy 
,, Caudry . . 
,, Awoingt . . 
,, Delsaux Farm 
,, Ytres 
,, Grevillers 



Beaulencourt . . No. 43. 



THE ADVANCE TO VICTORY 311 

Six motor ambulance convoys were allotted to the Third 
Army during the various periods of the advance, namely, 
Nos. 21, 6, 30, 27, 15 and 16. They were allotted for work 
with corps or as Army reserve. 

The advanced depots of medical stores in the Army were 
No. 15 at Frevent throughout the operations, No. 16 at Wavans, 
moving during the operations to Bac-du-Sud (Bailleulval) 
and Cambrai, and No. 34 at Gezaincourt and, from the 
beginning of October, at Grevillers. 



Medical Services with the First Army. 

The First Army did not become engaged in the active 
operations of the advance until the 26th August. At that 
time the situation of its casualty clearing stations was as 
follows : — 

At Anvin . . . . Nos. 2, 15 and 23. 

„ Ligny St. Flochel Nos. 7, 33 and 1. 

„ Pernes . . . . Nos. 6, 13 and 22. 

„ Wavrans . . No. 30. 

„ Mingo val . . Nos. 42 and 57. 

No. 12 Stationary Hospital at St. Pol was also under the 
First Army administration. 

Consequently, the distance from the front line of the most 
forward casualty clearing stations at Mingoval, north of 
Aubigny, on the 26th August was about twelve miles, and of 
those further back some twenty or more miles. The two 
casualty clearing stations at Aubigny had been moved to 
Mingoval during the earlier part of August in consequence of 
their positions near the railway station at Aubigny having 
become dangerous from long-distance artillery fire and air raids. 
Up to the 25th August the D.M.S. of the Army, Maj. -General 
H. Thompson, and his staff had no information regarding the 
impending operations. He had gone on leave only three days 
before the attack took place, but returned on the 28th August. 

The Battles of Arras. — Immediately after the attack was 
launched by the First Army on the 26th August, No. 23 CCS. 
was moved to the old casualty clearing station site at Agnez-les- 
Duisans. The D.M.S. of the Army had continued his policy 
of placing his casualty clearing stations under the administra- 
tive control of Corps D.Ds.M.S. Consequently, on the 27th 
August, responsibility for control of the C.C.Ss. of the Army 

(10134) BB 



312 MEDICAL HISTORY OF THE WAR 

had to be determined, and the D.M.S. issued the following 
orders :• — 

"To be administered by the VHIth Corps : — 

Nos. 1, 7 and 33 C.C.Ss. at Ligny and No. 30 CCS. at Wavrans. 
" To be administered by the Canadian Corps : — 

Nos. 42' and 57 C.C.Ss. at Mingoval, and any casualty clearing station, 
Nos. 23, 1 (Canadian) and 4 (Canadian), moving to or due to arrive 
at Agnez-les-Duisans. 
" To be administered by the 1st Corps : — 

Nos. 6, 13 and 22 C.C.Ss. at Pernes. 
"To be administered by the XXIInd Corps : — 

Nos. 2 and 15 C.C.Ss. at Anvin." 

No. 12 Stationary Hospital at St. Pol remained under the 
administration of the D.M.S. 

The number of wounded received into the First Army 
casualty clearing stations between the 26th and 31st August 
was : officers 412, other ranks 9,310, German officers 12, German 
other ranks 535. 

On the 28th August No. 23 C.C.S., and on 1st September 
No. 1 (Canadian) and No. 4 (Canadian) C.C.Ss., arrived at 
Agnez-les-Duisans. 

The Battle of the Canal du Nord. — The line of the First Army 
was advanced to near the Canal du Nord, between the Arras- 
Cambrai and Bapaume-Cambrai roads, by the 2nd September, 
when there was a lull in the fighting on this front until the 
27th September. No further moves of casualty clearing 
stations were made until the 12th and 16th September, when 
Nos. 6 and 15 C.C.Ss. were moved to Ruitz and placed under 
the administration of the 1st Corps D. D.M.S. The Indian 
section of the Lucknow CCS. was also attached to No. 6 CCS. 
at Ruitz. Later on casualty clearing stations were moved up 
on the right of the First Army front to Ficheux and Boisleux- 
au-Mont, in an area recently taken over from the Third Army. 
Nos. 22, 30 and 33 C.C.Ss. were transferred to this locality 
just before the attack of the 27th September against Bourlon 
and Cambrai in conjunction with the Third Army. At the 
same time the casualty clearing station positions at Ruitz 
and Pernes came into the Fifth Army area, and Nos. 13 and 
15 C.C.Ss. were then transferred to that Army. No. 6 CCS., 
however, remained at Pernes as a First Army unit. 

During the operations of the 27th September and following 
days, No. 1 CCS., at Boisleux-au-Mont, acted as a casualty 
clearing station for walking wounded ; and Nos. 22, 30 and 
33, at Ficheux, as casualty clearing stations for severely 
wounded. The wounded were being brought back to the 



THE ADVANCE TO VICTORY 



313 



railway station at Boisleux in closed trucks from Queant on a 
broad-gauge line of railway. Boisleux railway station was 
only 200 yards from No. 1 CCS. and arrangements were made 
there for the lying down wounded to be received and taken 
on by road to the casualty clearing stations at Ficheux. In 
advance of Queant there was a good network of field railways. 
Otherwise the only main route of evacuation which could be 
followed was the Arras-Cambrai road, and it was under shell 
fire and heavily congested with traffic. Roads south of the 
main road were in bad condition and mostly ran north and 
and south ; that is to say in a lateral direction and not directly 
back from the battle zone. 

The Third Army had two casualty clearing stations at this 
time also at Boisleux-au-Mont, with a special siding for ambul- 
ance trains, but this was not at the disposal of the First Army, 
which had consequently to send its lying down wounded to 
Ficheux, to be entrained there. 

The number of wounded received into medical units of the 
First Army during the September operations was as follows : — 





Offs. 


O.R. 


German. 




Offs. 


O.R. 


Sept. 1st to 7th 
Sept. 21st to 28th 
Sept. 29th to Oct. 5th 


491 
351 
336 


10,275 
7,276 
7,555 


44 
41 

5 


959 
725 
376 



During this period the D.M.S. carried out the policy of 
evacuation of wounded direct from advanced dressing stations 
to casualty clearing stations without an intermediate main 
dressing station ; but what he had in fact abolished was the 
advanced dressing station, as the resources of the field am- 
bulance tent divisions were concentrated at these dressing 
stations. The real advanced dressing stations were the collecting 
posts at which wounded were loaded on wheeled conveyances 
for transport to the dressing station. Owing to the bad state 
of the roads the broad-gauge railway from Queant to Boisleux 
was of immense assistance during the advance on Bourlon and 
Cambrai. 

The Battle of Cambrai.- — On the 9th October the Canadian 
Corps on the right of the First Army resumed the attack on 
Cambrai in conjunction with the operations of the Third Army, 
and advanced to the east of the town with less than 200 
casualties. Owing to the rapid advance the D.M.S. of the 



314 



MEDICAL HISTORY OF THE WAR 



First Army immediately ordered up No. 2 CCS. from Anvin 
and No. 57 C.C.5. from Mingoval on the following day by rail 
to near Queant, which was then the most forward railhead. 
Nos. 42 and 7 C.C.Ss. were also ordered to close and be ready 
to move from Mingoval and Ligny St. Flochel. These casualty 
clearing stations, however, were not moved till much later, 
but No. 1 and No. 30 from Boisleux and Ficheux were moved 
to buildings at Escaudoeuvres, north-east of Cambrai, on the 
18th and 20th October in anticipation of further fighting. 

A large civil hospital was in use as a corps rest station at 
Cambrai. It was placed under the administration of No. 22 
CCS., which was brought up from Ficheux on the 25th October. 
At the same time No. 23 CCS. was moved forward from 
Agnez-les-Duisans to Brebieres, three miles south-west of 
Douai on the Arras road, and No. 42 from Mingoval to Douai ; 
both units being accommodated in large buildings. No. 1 and 
No. 4 Canadian C.C.Ss. were next selected for transfer from 
Agnez-les-Duisans to a more forward area. The former was 
transferred to large buildings at Auberchicourt, between Douai 
and Valenciennes, and the latter to a large chateau in the Bois 
de Montigny about three miles north of Auberchicourt, which 
had originally been used as a sanatorium for tubercular diseases. 
No. 6 CCS., which had been at Ruitz in the Fifth Army area, 
was also moved to the Bois de Montigny at the end of October. 

The Final Advance. — During October the First Army did not 
suffer many casualties as compared with the Third and Fourth 
Armies, with which it was co-operating ; and the strain on its 
medical units was not great. 

Between the 5th October and 2nd November the number of 
wounded received into them was : — 





Offs. 


O.R. 


German. 




Offs. 


O.R. 


Oct. 6th to 12th 
Oct. 13th to 19th 
Oct. 20th to 26th 
Oct. 27th to Nov. 2nd 


149 
120 

143 


4,337 
3,517 
2,191 
2,839 


4 

4 
11 


149 
42 

160 
381 



The majority of the wounded in the last period were wounded 
on the 1st November, when the Canadian and XXI Ind Corps 
advanced on Valenciennes. Between then and the date of the 
Armistice 118 officers, 2,317 other ranks and 4 German officers 
and 105 German other ranks were wounded. 



THE ADVANCE TO VICTORY 315 

The situation as regards the casualty clearing stations of the 
First Army at the time of the Armistice was as follows : — 

No. 4 (Canadian) CCS. was opened at the " College des 
Jeunes Filles," Valenciennes, for all serious cases of all three 
corps of the First Army. 

Lighter cases of wounds and sickness were transferred by 
motor ambulance convoy from the VHIth Corps to Nos. 6 and 
42 C.C.Ss. at Bois de Montigny and Douai ; from the Canadian 
Corps to No. 1 (Canadian) CCS., at Auberchicourt, and to 
Denain, where No. 33 CCS. had been moved into a large 
Technical School ; and from the XXIInd Corps to No. 22 CCS 
at Cambrai, and Nos. 1 and 30 at Escaudoeuvres. 

Nos. 2 and 57 C.C.Ss., at Queant, were moving to Valen- 
ciennes, and No. 23, at Brebieres, was being closed. No. 7 
remained in the back area at Ligny St. Flochel. On arrival 
at Valenciennes No. 57 CCS. was established in the Convent of 
St. Saulve, a suburb of the town, and No. 2 in the " Hospice 
des Petites Soeurs des Pauvres " for the reception of French 
and Belgian civilian sick and wounded. 

No. 8 (Canadian) Stationary Hospital was being brought up 
to the Bois de Montigny ; and No. 6 CCS. then moved to a 
college in Valenciennes. Nos. 1, 23 and 30 C.C.Ss. were then 
ordered to close and remain parked. 



Medical Services with the Fifth Army 

The Fifth Army was reorganized as such at the end of June 
1918 under the command of General Sir W. Birdwood, but it 
had no D.M.S., until 22nd July, when Major-General J. J. 
Gerrard was appointed. Lieut. -Colonel Boylan Smith, however, 
was A.D.M.S., and carried on the administrative duties till 
then. Colonel Frankau was appointed consulting surgeon and 
Colonel Miller consulting physician. 

On the 1st July the Fifth Army took over one of the areas 
of the First Army, in the neighbourhood of Aire and Therouanne, 
with the Xlth and XHIth Corps. The following medical units 
were then in the area : — 

Casualty Clearing Stations — 
At Aire, Nos. 51 and 54. 
At Fines, No. 8. 
Motor Ambulance Convoys — 

No. 22 at Ferfay with XHIth Corps. 
No. 25 at Aire with Xlth Corps. 



316 MEDICAL HISTORY OF THE WAR 

Mobile Laboratories — 

No. 9 (Hygiene) at Therouanne. 
No. 20 (Bacteriological) at Aire. 
Stationary Hospital — 

No. 39 at Fort Gassion, Aire. 
No. 43 M.A.C. was added to the medical units as Army 
reserve convoy on the 6th July, and No. 32 CCS. on the 10th 
July. On the 14th July No. 51 CCS. was moved back from 
Aire to Coyecque, four miles south-west of Therouanne. The 
general policy during July was in fact to withdraw medical 
units from Aire, as they were liable to be shelled and bombed, 
and leave only an advanced operating centre in No. 54 CCS. 
which had replaced No. 39 Stationary Hospital at Fort Gassion. 
Consequently, the medical situation in the Fifth Army at the 
time of the British advance was as follows : — 
No. 39 Stationary Hospital parked at Desvres. 
Nos. 8 and 32 C.C.Ss. . . at Elnes 
No. 51 CCS. . . . . at Coyecque. 

No. 54 CCS. . . . . at Aire. 

No. 1 Advanced Depot of near Elnes at Wavrans sur l'Aa. 
Medical Stores. 

No. 22 M.A.C with XHIth Corps at Ferfay. 

No. 25 M.A.C with Xlth Corps at Fort Gassion, 

Aire. 
No. 43 M.A.C . . . . as Army Reserve at Clety. 

No. 9 (Hygiene) Laboratory at Therouanne. 
No. 16 (Bact.) Laboratory at Elnes. 
No. 20 (Bact.) Laboratory at Coyecque. 
No. 39 (Bact.) Laboratory at Fort Gassion. 
A Portuguese division was with the Fifth Army with Nos. 
4, 6 and 8 Portuguese field ambulances. 

Immediately after the success of the Fourth Army offensive 
the D.M.S. of the Fifth Army commenced to move his casualty 
clearing stations forward again. He brought No. 32 up to 
Lozinghem Chateau, and had it replaced at Elnes by a new 
casualty clearing station, No. 63, which had been sent to it 
from Senlis after the operations of the British with the French 
Groupe d'Armees de Reserve on the Marne. 

A second advanced depot of medical stores, No. 31, was also 
sent to the Fifth Army and placed at Fort Gassion, Aire. 

The Fifth Army, throughout the advance to victory 
was engaged in following the enemy in his retreat from 
the area between Armentieres and Lens. There was no 



THE ADVANCE TO VICTORY 



317 



serious resistance, and the Army entered Lille in the middle 
of October without opposition. 

The number of wounded received into its C.C.Ss. during 
different periods of its advance was consequently small, as is 
shown in the following table : — ■ 









Germans. 




Offs. 


O.R. 














Offs. 


O.R. 


Sept. 1st to 7th 


34 


804 


— 


6 


Sept. 21st to 28th 


30 


484 


— 


8 


Sept. 29th to Oct. 5th 


79 


1,179 


— 


22 


Oct. 6th to 12th 


26 


629 


— 


2 


Oct. 13th to 19th .. 


30 


658 


■ — ■ 


1 


Oct. 20th to 26th 


28 


633 


— 


3 


Oct. 27th to Nov. 2nd 


45 


1,087 


— 


— 


Nov. 3rd to 9th 


33 


1,038 


1 


2 



In the middle of September the 1st Corps, in the northern 
sector of the First Army, was taken over by the Fifth Army, 
and with it one of the casualty clearing stations at Pernes 
(No. 13) and one at Ruitz (No. 15 ), together with No. 12 M.A.C. 
Two casualty clearing stations of the Second Army, Nos. 1 
and 2 (Australian), were also given to the Fifth Army and 
placed in St. Venant on the 15th September. Thereafter 
the casualty clearing stations followed the advance of the 
Army in the following order : — 



Date. 


CCS. 


From. 


To. 


Oct. 10th . . 


No. 13 


Pernes 


Cambrin. 


>> »» 


No. 54 


Aire 


Cambrin. 


it >> • • 


No. 51 


Coyecque 


Estaires (Nouveau Monde) . 


„ 12th .. 


No. 2 Aust. 


St. Venant 


Estaires (Nouveau Monde). 


„ 22nd . . 


No. 15 


Ruitz 


Don. 


„ 24th . . 


No. 32 


Lozinghem 


Don. 


„ 27th . . 


No. 1 Aust. 


St. Venant 


Fretin. 


„ 31st .. 


*No. 63 


Second Army . . 


Lille and Ascq. 


" 


No. 13 


Cambrin 


Ascq. 



* Went from Elnes to the Second Army on 13th September and returned 
to the Fifth Army on 31st October. 



No. 39 Stationary Hospital was moved to the Hopital 
St. Sauveur, Lille, on the 27th October from Desvres. 



318 



MEDICAL HISTORY OF THE WAR 



The Fifth Army advanced as far as Ath, and then settled 
down after the Armistice in Lille and the neighbouring towns, 
the casualty clearing stations being established in buildings in 
Tournai, Courtrai, St. Andre and Tourcoing. Nos. 62, 11, 8 and 
10 C.C.Ss. were taken over from the Second Army in the last 
three towns in situ between the 15th and 17th November. 
No. 54, which remained at Cambrin, Nos. 15 and 32 at Don, 
Nos. 13 and 63 at Ascq, and No. 51 at Tournai, where it arrived 
on the 12th November, were handed over in situ to the First 
Army on the 26th November. 

Nos. 10, 4, 3 (Canadian) and No. 1 (New Zealand) Stationary 
Hospitals also came into the Fifth Army administration from 
the Second Army during November. They were respectively 
at Tourcoing, Longuenesse (with a section for Chinese at 
Moulle), Malassise and Bourg (near Wisques) at that time. 



Medical Services with the Second Army 

The Second Army advanced rapidly, experiencing much less 
serious opposition than the First, Third and Fourth Armies. 
Its operations, as already noted, were conducted under the 
command of H.M. The King of the Belgians, and its advance 
was chiefly over the devastated Ypres Salient, which had been 
the scene of so many battles since October 1914. It was, 
however, engaged in heavy fighting between the 28th September 
and 2nd October, with the Ilnd, XlXth, Xth and XVth Corps 
on the Ypres front, and again on the 14th and 19th October at 
Courtrai. 

The wounded who came into the medical units of the Second 
Army during the advance were as follows :■ — 





Offs. 


O.R. 


Germans. 












Offs. 


O.R. 


Sept. 1st to 7th 


182 


3,564 


2 


85 


Sept. 21st to 28th 


125 


2,658 


7 


169 


Sept. 29th to Oct. 5th 


272 


5,822 


4 


216 


Oct. 6th to 12th 


10 


652 


1 


2 


Oct. 13th to 19th .. 


214 


5,129 


15 


463 


Oct. 20th to 26th 


188 


3,422 


2 


158 


Oct. 27th to Nov. 2nd 


66 


1,350 


5 


154 


Nov. 3rd to 9th 


23 


424 


— 


2 



THE ADVANCE TO VICTORY 319 

In the first week of August 1918 the D. M.S. of the Army, 
Major-General Guise Moores, had his casualty clearing stations 
placed as follows : — 



Unit. 


Locality. 


No. 1 (Australian) CCS. 

No. 2 „ „ 

No. 36 CCS 

No. 64 

Nos. 10 and 44 C.C.Ss 

No. 3 (Australian) and No. 2 (Canadian) C.C.Ss. 

No. 58 CCS 

No. 62 

No. 18 „ 

No. 11 „ 


Blendecques. 

Watt'en. 

Near Bergues. 

Esquelbecq. 

Longuenesse. 

Arneke. 

Malassise. 

Moulle. 



No. 1 (Canadian) and No. 4 (Canadian) C.C.Ss. were at 
Arneke, but closed, having been sent there, it will be remem- 
bered, to divert the enemy's attention from the impending 
attack of the Fourth Army. No. 17 CCS. was also with the 
Second Army, but was parked at Bourg, near Wisques. 

There were three stationary hospitals, No. 10 at Clerques 
(near Licques), No. 4 at Arques, and No. 1 (New Zealand) at 
Bourg. No. 9 B.R.CS. Voluntary Hospital (Millicent, Duchess 
of Sutherland's) was at Longuenesse, but closed. 

Advanced depots of medical stores were at Blendecques 
(No. 2), Arneke (No. 11) and Esquelbecq (No. 2 Canadian). 

The mobile laboratories with the Army were : — 
No. 1 (Bact.) with No. 10 CCS. near Bergues. 
No. 8 (Bact.) with No. 64 CCS. at Watten. 
No. 11 (Bact.) with No. 2 (Australian) CCS. at 

Blendecques. 
No. 4 (Hygiene) at Bourg. 

The motor ambulance convoys were Nos. 2, 4, 5, 14, and 20. 
Nos. 4 and 14 were attached to the Ilnd and XVth Corps 
respectively. The others were directly under the control of the 
D.M.S., with two sections of No. 2 attached to the XlXth 
Corps and one of No. 5 to the Xth Corps. There was also 
a voluntary convoy of the First Aid Nursing Yeomanry 
(F.A.N.Y.) consisting of thirty cars for local duty at St. Omer, 
under the A.D.M.S., whose area was then in the Second Army. 

In August the Second Army was engaged in minor operations, 
during which Oultersteene was occupied on the 18th August 
and Bailleul on the 30th of the month. As the enemy was 
then retiring preparations were made for moving casualty 



320 



MEDICAL HISTORY OF THE WAR 



clearing stations forward. No. 17, after a trial move with 
nine lorry loads to Arneke, was opened there on the 27th 
August, but was transferred to Ana Jana Siding on 4th Sep- 
tember together with No. 1 (Australian) and No. 2 (Australian) 
C CSs. No. 4 Stationary Hospital was, however, being 
moved from Arques to Recques in a back area. 

At the beginning of September the Ilnd American Corps 
went into line with the Second Army, in the Canal and Dicke- 
busch sectors, before its transfer to the Fourth Army. 

On the 14th and 19th September, No 1 (Australian) and 
No. 2 Australian C.C.Ss. left the Second for the Fifth Army, 
and were replaced by No. 8 and No. 63 at Ana Jana Siding 
and Ebblinghem respectively. There was then a general move 
forward of the casualty clearing stations to the old casualty 
clearing station sites behind the Ypres salient as follows : — 



CCS. 


From 


To 


No. 36 

No. 3 (Australian) 

No. 2 (Canadian) 

No. 10 

No. 62 


Watten 
Esquelbecq 
Esquelbecq 
Near Bergues 
Arneke 


Rousbrugge. 

Haringhe (Bandaghem). 

Remy Siding. 

Remy Siding. 

Remy Siding. 



The moves were made in fifty lorries placed at the disposal 
of the D.M.S. for the purpose. 

No. 9 B R.C.S. hospital was also permitted at the same 
time to move forward to Ana Jana Siding. 

Nos. 58 and 18 C.C.Ss. at Longuenesse and Malassise were 
closed, preparatory to their being transferred at the end of 
the month to the Third Army ; and No. 10 Stationary Hospital 
was then ordered to move into the hospital huts at Longuenesse. 

The Battle of Ypres. — During the attack and rapid advance 
beyond the Messines and Passchendaele ridge between the 
27th and 30th September, the conditions affecting evacuation 
of wounded in the Second Army became very difficult. There 
was incessant rain on the 30th September and the roads on 
the Passchendaele ridge were much damaged. Consequently 
wounded had to be carried back long distances by hand to 
main dressing stations. 

After these operations the two casualty clearing stations 
furthest back, No. 11 from Moulle and No. 44 from Bergues, 
were brought forward to Brielen, near Ypres, on the 6th and 
7th October, and No. 36, from Roosbrugge, was also transferred 
there a few days later. At the same time No. 3 (Canadian) 



THE ADVANCE TO VICTORY 



321 



Stationary Hospital, which it will be remembered had been 
sent from the Citadel, at Doullens, to Rouen on the 18th 
August, was brought up to the Second Army area and opened 
at Mai assise. 

The Battle of Courtrai. — During the whole of the last two 
weeks in October, the Second Army continued to make rapid 
advances in Belgium, at times against strong resistance, and 
by the end of the month had passed through Roubaix, 
Tourcoing, Menin and Courtrai, and had reached the line of 
the Scheldt. There was consequently a wide area of devas- 
tated country between the divisions of the army and the 




No. 63 Casualty Clearing Station at Ebblinghem, 1918. 

casualty clearing stations across which ambulance transport 
by road or rail was for a time extremely difficult. Fortunately 
the buildings in towns and villages east of the Passchendaele 
ridge had not suffered much damage and were available for 
medical units. 

No. 8 and No. 17 C.C.Ss. were moved to Les Trois 
Tilleuls on the 20th October ; Mouveaux was occupied by 
No. 2 (Canadian) CCS. on the 22nd October ; No. 64 and 
No. 3 (Australian) C.C.Ss. were moved to Dadizeelehoek on 
the 23rd October; No. 11 was moved to St. Andre on the 
26th October ; No. 10 to Tourcoing on the 1st November, and 
No. 44 to Courtrai (Heule) on the 3rd November. These last 
two units were moved by rail from Brielen and Remy Siding. 



(10134) 



BB* 



322 MEDICAL HISTORY OF THE WAR 

On the 6th and 7th November, No. 36 CCS. was brought up 
to Sweveghem (St. Andre) and No. 17 to Deerlyck (Toureoing) . 
The voluntary hospital, No. 9 B.R.C.S., was also brought by 
rail into Belgium and placed at Roubaix on the 4th November. 

Some further moves took place just before the Armistice, 
when the situation of medical units in the Second Army was 
as follows : — 

Deerlyck . . No. 17 CCS. 

Mouveaux . . No. 2 (Canadian) CCS. 

Dadizeelehoek . . No. 64 and No. 3 (Australian) C.C.Ss. 

Toureoing . . No. 10 CCS. 

Sweveghem .. No. 36 CCS. (closed). 

Courtrai. . . . No. 44 CCS. 

St. Andre .. No. 11 CCS. 

Roubaix . . No. 9 B.R.C.S. Hospital (closed). 

The stationary hospitals at Longuenesse, Malassise and 
Bourg, in the St. Omer area, were transferred in situ to the 
Fifth Army. No. 10 Stationary Hospital was, however, 
retained by the Second Army, and was transferred to 
Arneke on the 9th October. It was brought up to Toureoing, 
after the Armistice, on 15th November, and was subsequently 
transferred to the Fifth Army area there. 

The Medical Situation generally during the Advance. 

In reviewing the medical situation generally during the 
battles the main features were the large numbers of casualties 
in the Fourth and Third Armies and the right of the First 
Army ; the comparatively few casualties in the operations of 
the Second and Fifth Armies in Flanders, but at the same 
time the rapid and extensive advance of these two armies 
over the devastated area of the Ypres-Armentieres sectors to 
the large towns of France and Belgium beyond ; and the 
general handling and management of the casualty clearing 
stations and transport to meet these conditions. Another 
factor which also came into operation and affected the medical 
services was the provision that had to be made for the civilian 
populations and released prisoners of war as well as for the 
numerous sick and wounded amongst the German prisoners. 

The special medical problems of all five Armies were 
undoubtedly those of transport. The number of casualty 
clearing stations was adequate in all Armies, but they were 
from the very commencement much further back than in 
previous battles. This handicap was accentuated too by the 
rapidity of the advance, especially in the case of the Second 



Chart showing daily totals of Admissions to Casualty Clearing Stations of the First, Second/Third, Fourth & 
Fifth Armies during "The Advance to Victory 1818 




2848C SOeo/m ISOO II.Z3 



Heavy iine indicates British . 



Light i/ne indicates German. 



THE ADVANCE TO VICTORY 323 

Army. Motor ambulance convoys and motor ambulance 
transport generally were also adequate in numbers ; the num- 
ber of convoys was indeed increased at the end of October 
by the arrival of No. 47 and No. 48 ; but the damage to the 
roads and the general traffic prevented their working as rapidly 
and as uninterruptedly as might otherwise have been the 
case. They received little or no assistance from light field 
railways, although advantage was taken of these in places. 
The ambulance trains also ran with less regularity, owing to 
delays and damage to railway lines. There were, in fact, at 
times long gaps between the more advanced medical units 
and the nearest railheads. 

It was fortunate, therefore, that the number of wounded in 
any one Army on any one day was considerably less than had 
been the case in some of the previous battles ; but the 
aggregate number of wounded when two or more Armies 
were actively fighting at the same time threw a very great 
strain on evacuation by ambulance trains. Consequently, 
there was an accumulation of wounded in casualty clearing 
stations, pending the arrival of the trains, which made the 
work in these units particularly arduous. The railheads, 
especially in the north, did not advance as rapidly as the troops, 
and the question arose whether it was best to push casualty 
clearing stations in advance of railheads and have two stages 
of road transport through casualty clearing stations to railheads 
or to retain the casualty clearing stations at railheads only 
and bring the wounded back by one long road journey on cars. 
As a rule the latter alternative was adopted, but in that 
case advanced operating centres were established, either in 
field ambulances or in advanced casualty clearing stations, 
for urgent cases and for those unfit for the,long transport back. 

Experimental moves of casualty clearing stations were made 
in some Armies to test the rapidity with which a casualty 
clearing station could be moved and re-establish itself, and 
the amount and nature of equipment that it was possible to 
carry on nine or more lorries. In one Army, the First, an 
officer and twenty-five men of the R.E. were attached to the 
D.M.S. staff for engineering work on the site selected for each 
new casualty clearing station. They were of the greatest help. 

The largest number of wounded received in one day into 
casualty clearing stations of an Army was 7,643, on the 8th 
August, in the Fourth Army, but as no other Armies were 
then engaged this number must be regarded as small in com- 
parison with the number of wounded on the first day of the 



324 MEDICAL HISTORY OF THE WAR 

battles of Loos, in 1915, and the Somme, in 1916. Details of 
the wounded received into each Army day by day of the 
advance to victory will be found in Appendix C. The 
aggregate of wounded day by day in all Armies is shown on 
the chart. It will be seen that the maximum was on the 
27th, 28th and 29th September. This maximum, however, did 
not exceed the maximum on the first days of the battles of 
Loos and the Somme. 

One of the difficulties which arose in consequence of more 
than one Army being engaged at the same time was the difficulty 
of providing surgical teams at each of the casualty clearing 
stations in sufficient numbers to enable surgical work to be 
carried out to the same extent as in the Battles of Ypres in 
1917 ; but here again the smaller number of wounded counter- 
balanced to some extent the smaller number of surgical teams 
available for each Army. 

The large number of wounded enemy prisoners added 
greatly to the work of the medical units, as may be gathered 
from the statistics given above and in the appendix. The 
orders were to retain them for treatment in hospitals in France. 
The effect of this was to interfere to some extent with the 
arrangement by which delayed primary suture of wounds 
amongst the British was to be carried out at the base hospitals ; 
for, owing to the large number of beds occupied by German 
wounded, many of the British wounded had to be evacuated 
to the United Kingdom before primary suture was completed. 

Although the number of wounded was considerably less 
during the fighting in open country in October and November 
the work thrown on the medical services was greater than ever. 
Influenza of a grave type, with broncho-pneumonia and other 
complications, attacked the troops about the middle of October, 
and continued till the end of the operations. During the week 
ending 2nd November, for example, there were 11,936 admis- 
sions, with 625 deaths, from this disease, and during the following 
week 11,877 admissions and 878 deaths — figures which show 
the extent and gravity of the epidemic. 

Another source of strain on the medical services was the 
necessity of taking over the medical charge of large numbers 
of sick and infirm men, women and children amongst the civil 
populations of the liberated towns and villages. Casualty 
clearing stations such as No. 2 at Valenciennes were in some 
instances allotted for this work alone. 

The casualties amongst the personnel of the medical services 
from the beginning of the advance to the time of the Armistice 



THE ADVANCE TO VICTORY 325 

were 64 officers and 249 other ranks killed or died of wounds ; 
and 186 officers and 1,667 other ranks wounded. Six other 
ranks also were missing. 

Of the officers killed or died of wounds 37 belonged to the 
R.A.M.C, 7 to the Canadian and 6 to the Australian Army 
Medical Corps, 1 to the New Zealand Medical Corps, 1 to the 
Royal Navy, and 12 to the U.S.A. Medical Corps. 

The Medical Situation after the Armistice. 

After the Armistice arrangements were made for the Second 
and Fourth Armies, covered by Cavalry Divisions, to advance 
into Germany, each army consisting of four corps of four 
divisions each. The advance commenced on the 17th November 
and progressed by definite stages. The German frontier was 
crossed on the 1st December, and then, owing to the narrow 
front allotted to the British forces, the Second Army only 
continued its advance. It consisted of the Hnd, Vlth, IXth, 
and Canadian Corps, with eleven divisions ; the 9th, 29th and 
New Zealand in the Ilnd Corps ; the Guards, 2nd and 3rd in the 
Vlth Corps ; the 1st, 6th and 62nd in the IXth Corps ; and the 
1st Canadian and 2nd Canadian divisions in the Canadian Corps. 
Cologne was occupied by cavalry on the 6th December and next 
day by infantry brought up by rail. Cavalry crossed the Rhine 
on the 12th December and occupied the Cologne bridgehead. 
They were followed by columns of infantry who crossed at 
Cologne and Bonn. Eventually these towns and Diiren and 
Euskirchen were each occupied by a corps of the Army. The 
Army headquarters were established at Cologne. 

The Fourth Army occupied the liberated territory in Belgium, 
with headquarters at Namur. The Cavalry Corps established 
its headquarters at Spa, in the Ardennes. 

The Fifth, First and Third Armies, with headquarters 
respectively at Lille, Valenciennes and Flexicourt (on the 
Somme between Abbeville and Amiens), were left to clear up 
the devastated areas and administer the vast numbers of labour 
corps troops and prisoners of war engaged in that work. 

The medical services were called on to make provision for all 
of these and for the Armies on and behind the Rhine, as well 
as for the large numbers of liberated prisoners, who found their 
way to the British lines. Motor ambulance convoys were 
sent into the interior of Germany to collect prisoners who 
might be unable to move. Detachments of motor ambulance 
cars from No. 8 and No. 20 M.A.Cs. in this way explored the 
interior up to the Polish frontier. They all returned by 14th 
February except one, which had to be abandoned in the snow 
at Allenstein in East Prussia. 



326 



MEDICAL HISTORY OF THE WAR 



The general distribution of the casualty clearing stations 
and the stationary hospitals in Army areas after the new 
positions had been taken up was as follows : — 



Second Army. Bonn 



Fourth Army. 



Third Army. 



Cologne . . 

Diiren 

Euskirchen 

Charleroi 

Huy 

Maubeuge 

Namur . . 
Nos 

Busigny 

Cambrai . . 

Caudry . . 

Doullens . . 

Grevillers 

Le Quesnoy 

Pont Remy 

Solesmes . . 

Tincourt . . 

Fillievres. . 

Amiens . . 
Nos. 38 
Busigny 



Nos. 1 (Canadian) and 2 (Canadian) 
C.C.Ss. 

Nos. 44, 36 and 64 C.C.Ss. 

No. 17 CCS. 

No. 3 (Australian) CCS. 

Nos. 20 and 55 C.C.Ss. 

No. 50. 

Nos. 5 and 47. 
. . No. 48. 
61 and 53 at Gembloux and Houyet were closed. 
. . Nos. 12 and 37th C.C.Ss. 
. . No. 22 CCS. 
.. Nos. 19 and 49 C.C.Ss. 
.. No. 18 CCS. 
. . No. 56 CCS. 
. . No. 3 (Canadian) CCS. 
. . No. 46 CCS. 
.. No. 4 CCS. 
. . No. 58 CCS. 
. . No. 6 Stationary Hospital. 
. . No. 41 Stationary Hospital. 
45 and 59 C.C.Ss. at Awoingt, No. 37 at 
No. 21 at Caudry, No. 29 at Delsaux Farm, 



First Army 



No. 41 at Le Cateau, and No. 34 at Solesmes were closed. 



Fifth Army. 



Agnez-les-D uisans 

Ascq 

Auberchicourt . . 

Bois de Montigny 

Denan 

Don 

Douai 

La Louviere 

Mons 

St. Saulve 

Tournai 

Valenciennes 

Warlus 

St. Pol . . 

Ath 

Courtrai 

Hal 

Lillers 

St. Andre 

Tourcoing 

Longuenesse 
Moulle 

Lille 
Malassise 



No. 
No. 
No. 
No. 

No. 



7 CCS. 
13 CCS. 
23 CCS. 
6 CCS. 
33 CCS. 



No. 15 CCS. 

No. 42 CCS. 

No. 30 CCS. 

No. 1 and No. 4 (Canadian) C.C.Ss. 

No. 57 CCS. 

No. 51 CCS. 

Nos. 2 and 32 C.C.Ss. 

Lucknow CCS. 

No. 12 Stationary Hospital. 

No. 2 (Australian) CCS. 

No. 62 CCS. 

No. 1 (Australian) CCS. 

No. 8 Portuguese Field Ambulance. 

No. 11 CCS. 

Nos. 8 and 10 C.C.Ss. and No. 10 

Stationary Hospital. 
No. 4 Stationary Hospital. 
No. 4 Stationary Hospital (Chinese 

Section). 
No. 39 Stationary Hospital. 
No. 3 (Canadian) Stationary Hospital. 

Collecting stations for liberated prisoners of war were formed 
by the French immediately after the Armistice at Douai, 
Cambrai, Valenciennes, Maubeuge, Lille, Roubaix, Arras and 
Amiens in British army areas or lines of communication area, 
and for a time the British Medical Services assisted in the work 
of these centres. 



CHAPTER XVIII. 

THE MEDICAL SERVICES WITH THE BRITISH FORCES IN ITALY. 

BRITISH medical services were employed in three different 
spheres of activity in Italy, namely, on the Mediterranean 
Line of Communication between Taranto and Cherbourg ; 
with British artillery operating under the Italian command on 
the Carso, north of Trieste, until and during the Austrian 
offensive of October and November 1917 ; and with the British 
Expeditionary Force sent to Italy in November and December 
1917 when the Italians had retired to the line of the Piave after 
that offensive. 

The Mediterranean Line of Communication. 

The formation of a Mediterranean Line of Communication, or, 
as it was at first designated, an Eastern Line of Communication, 
was the first definite organization of a British medical service 
in Italy. By the end of 1916 the transport of reinforcements to 
and the evacuation of sick and wounded by sea from Macedonia 
and Eastern theatres of war were interrupted by the intensive 
submarine warfare in the Mediterranean, and in January 
1917 the possibility of establishing an overland route between 
Taranto and Cherbourg, thus limiting the sea passage to 
shorter sea routes from Egypt and Greece to the south of 
Italy, was considered at the War Office. 

The new line was then reconnoitred in January and February 
1917 by a railway and engineer staff, to which an officer of the 
R.A.M.C., Colonel J. C. B. Statham, was attached. Colonel 
Statham made a second reconnaissance in May 1917 and, after 
reporting on its medical and sanitary organization, was immedi- 
ately afterwards appointed A.D.M.S. of the Mediterranean 
Line of Communication, with headquarters at Lyons. Two 
D.A.Ds.M.S., one for the Italian section and one for the French 
section of the line, and medical officers for embarkation duties 
at Cherbourg and Taranto were appointed to work under him. 
In August 1917, the headquarters were transferred to Paris 
and control of the line was then taken over by the War Office, 
Colonel Statham being graded on the 1st October as a D.D.M.S. 



328 MEDICAL HISTORY OF THE WAR 

Tented and hutted camps were prepared at Cherbourg, 
St. Germain au Mont d'Or (near Lyons), Faenza (near Bologna) 
and Taranto, with accommodation for 2,000 men at the first 
three camps and for 5,000 at Taranto. Hospitals for 50 beds 
were organized at each, except at Taranto, which had a 200-bed 
hospital. 

At various stations on the line, both in Italy and France, 
haltes repas, or rest and refreshment stations, were organized at 
four to eight-and-a-half hours' journey intervals in order to 
feed the men and give them an opportunity of getting out of 
the train. At the camps at Faenza and St. Germain they rested 
for four to six hours and were served with a hot meal. 

Four sanitary sections were allotted for sanitary work at 
the camps and haltes repas : No. Ill Sanitary Section for 
Cherbourg and the haltes repas between it and St. Germain, 
No. 109 at St. Germain and for the haltes repas between it and 
the Italian frontier, No. 110 at Faenza and for the first four 
haltes repas in Italy, and No. 112 for the remaining three 
haltes repas and the camp at Taranto. 

Each halte repas was in charge of a N.C.O. of the sanitary 
section and two other ranks. The equipment of a halte repas 
consisted of 4 Soyer's stoves, 125 camp kettles, 125 washing 
tubs and 150 latrine buckets. 

In addition to the British haltes repas there was a series of 
French and Italian " infirmeries de gare," or medical stations, 
along the line at distances of about 100 kilometres apart, 
available to receive any sick unfit to continue the journey. 

The total length of the line was approximately 1,400 miles. 
The whole of this medical organization, as shown on the 
sketch maps, was ready by the end of June 1917. 

The requirements in medical personnel were 24 medical 
officers, 23 nursing sisters or staff nurses and 247 other ranks. 
Medical and surgical supplies were drawn from No. 3 Base 
Depot of Medical Stores, Rouen. 

At the end of June 1917, when native labour corps began 
to arrive at Taranto for duty on the line, additions of fifty beds 
for native labour were made to each of the four hospitals. 

No. 35 Advanced Depot of Medical Stores was sent to Taranto 
and an equipment of medical panniers, reserve dressings and 
fracture box was placed on each of the troop trains. 

On the Italian sector of the line special arrangements had 
to be made in consequence of the prevalence of malaria in its 
more southernly portions and in consequence of the diffi- 
culties in connexion with water supply. At Castellamare 







r O s ^' HERB0URG 






xV V"^ 




1 ^b c 






1 .2 






I & 




< 


1 <J 0) 
1 Jo «J 








ffi SURDON 1 


<0 






Lel Mans £j 







i /^ 
i / 


o Paris 


CQ 

a: 


1 H° 


' P»ERRE Hecudamarftrs of 
LEd Corps «. \ ~ 


s 


Tours £ft 


J D.DM.S. 


o 


i >v 

1 ^ 

1 






i \ 

• rx Vf\ 

\ Bourses yH 










7 


WSaincaize 




/ 


"~^x>iv--i- 




\ 
\ 


MoULINSlffi ^^ 

T \ 




\ 


1 \ 




\ 


Paray m \ 




\ 


LE MONIAET \ 
/ V 




\ 






ipn<S T ' Germain au 




y Mont d'0r\ 




S< \ 


Lyons H^-v G&^Ai*£ \ 

N * C -^A*^ French \ 
] Section) \ 










5° » 


i c Fn Chambery\ 
\ x-2 \ v 

\ & 7 

\ C I \ 
^ <2 ffl MoDANE. 1 

v 5^-; — \ 

/ cfi Turin n n 







QCamp BB British Hatte Repas {£ Frenck Medical 5tatibn 
Hospital §@ British Halte Repas and French Medical Station 

MEDICAL ARRANGEMENTS ON THE MEDITERRANEAN 
LINE OF COMMUNICATION, FRENCH SECTION. 

l3.284BC.5060/f<H./SOO.t/.S3. H.M.S 0, Cr 




QCamp 

and 
Hospital 



09 British Halte, Repas ® Italian Medici Stcxtioa 
QQ Rritish Halte Repos and. Italian Medical Station 



MEDICAL ARRANGEMENTS ON THE MEDITERRANEAN 
LINE OF COMMUNICATION, ITALIAN SECTION. 



2348C. Soeo//*-/ I500.IIZ3. 



H M SO.Cr 



MEDICAL SERVICES IN ITALY 329 

quinine and at Faenza second water bottles filled with sterilized 
water were issued to all troops passing southward of these places. 
The water bottles were collected at Taranto and re-issued for 
use as far as Faenza by troops proceeding northwards. 

A medical officer, Major Mattei of the Australian Army 
Medical Corps, who was a Maltese by birth and spoke Italian, 
was appointed liaison officer with the Italian medical authorities 
and thus obviated difficulties and misunderstanding which 
arose at first on the Italian section owing to mutual ignorance 
of each other's language on the part of the British and Italian 
medical authorities. 

These arrangements held good until a British Expeditionary 
Force was sent to co-operate with the Italian Army on the 
Austrian front, when a new line of communication was formed 
between Italy and Marseilles and the medical arrangements of 
the Italian section of the line were placed under the D.M.S. 
of that force. 

But in the meantime Taranto as a base had grown considerably 
in size and importance, and in September 1917 it became necess- 
ary to expand both the European and native hospitals there to 
500 beds each, and to employ five additional sanitary squads. 
Segregation camps for both Europeans and natives, and also 
a native labour transit camp, were formed. The expanded 
European hospital was then designated No. 79 General Hospital, 
and the hospital for native labour No. 6 Native Labour Hospital. 
No. 79 General Hospital was equipped for 1,100 beds, and there 
was, in addition, a small hospital for the British West India 
battalions which were on duty there. 

The camps at Taranto at that time were organized to 
accommodate about 10,000 in huts and tents. Owing to the 
prevalence of malaria in the locality all the huts were made 
mosquito-proof and mosquito nets were supplied for use in 
the tents. 

Much difficulty was experienced at first in maintaining a 
satisfactory standard of sanitation in these camps, owing to 
troops passing through them in large numbers before con- 
structions had been completed, but on the whole a high 
standard was eventually obtained. Lieut. -Colonel Robertson, 
I.M.S., was placed in sanitary and administrative charge, 
and Colonel Statham maintained a constant pressure on all 
concerned to expedite the necessary works. 

The journey from Cherbourg to Taranto usually lasted 
two or fnree days, but ambulance trains conveying sick 
or wounded coming from eastern theatres of war completed 
the journey from Taranto to Cherbourg much more quickly. 

(10134) CC 



330 MEDICAL HISTORY OF THE WAR 

Nos. 39 and 43 Ambulance Trains were employed on this 
duty, and proved admirably suitable for carrying sick on 
these long journeys. The ordinary trains carrying rein- 
forcements were run into sidings to let the ambulance 
trains through. Arrangements had been made in the summer 
of 1917 to run a weekly service of trains for conveying 500 
sick and wounded from Taranto. Two hundred and fifty 
were expected to be lying-down cases, and the ambulance 
trains were reserved for them. The remaining cases were 
carried in special ambulance coaches attached weekly to the 
returning troop trains. A large number of these cases were 
malaria convalescents or malaria-infected men from Macedonia, 
whom it was decided to send to England under what was 
designated the " Y " scheme. 

Medical Arrangements for British Artillery with the 
Italian Army. 

While this line of communication was being established, 
two groups of British heavy artillery, each of four batteries, 
were attached in April and May 1917 to the Italian Third 
Army in the Carso area east of the Isonzo. To each of these 
batteries a medical officer, N.C.O. and four other ranks 
R.A.M.C. were attached. The administrative headquarters 
were situated at Gradisca. Major E. F. Eliot, R.A.M.C, 
was appointed D.A.D.M.S. for medical administrative duties 
and arrived at headquarters on 13th April 1917. He was 
invalided in August and was succeeded by Lieut. -Colonel 
B. H. V. Dunbar. 

A hospital of fifty beds, expanded in May to one hundred 
and fifty under canvas, was established at Villa Freifeld, near 
Gradisca, under the command of the D.A.D.M.S., and two 
groups of two dressing stations each were organized behind 
the batteries for the reception of the sick and wounded before 
transfer to hospital. The dressing stations were at Doberdo, 
Debeli, Pec and Coteci, with a medical officer in charge of 
each. A senior medical officer was placed in command of 
each of the two groups, and was responsible for the general 
medical and sanitary condition of the areas occupied by the 
batteries. 

Sick and wounded were evacuated from the dressing station to 
the hospital by six ambulance cars provided by the British 
Red Cross Society in Italy. The British Red Cross Society 
also provided equipment for the hospital, and under the 
British Ambassador, Sir Ronald Rodd, and Lord Monson, 



© -s 




'^••il^-*«Sj£V 



N 

o 
o 



s: q 



<a 



<» 



.CD 



-X 



5^ 



O 
CO 

o 

CO 

o 



a. 



to 



<^ 0) 



CO 




o 

e 



X. 



MEDICAL SERVICES IN ITALY 331 

the British Red Cross Commissioner, helped in a variety of 
ways with personnel, equipment and transport to complete 
the organization of a medical service for the British artillery. 

At first there was no direct line of communication between 
Italy and the lines of communication of the British Expedition- 
ary Force in France. Several of the British sick and wounded 
had to be transferred, consequently, to Italian hospitals, and 
R.A.M.C. personnel was detailed for duty in them. 

In the middle of May Sir Walter F. Becket, an Englishman 
resident in Turin, offered a hospital of fifty beds, which he 
was maintaining there, as an auxiliary hospital for British 




Italian hospital tent. 

casualties. He agreed to provide and maintain the equipment, 
the B.R.C.S. in Italy provided the staff, and the Italian 
authorities provided rations. The offer was accepted, and 
the British authorities agreed to reimburse to the B.R.C.S. 
expenditure incurred in payment of the staff. An officer of 
the R.A.M.C. was appointed registrar, and a N.C.O., R.A.M.C, 
was placed in charge of stores and equipment. The hospital 
opened in the early part of June. In the meantime the 
hospital at Villa Freifeld, which was within the range of hostile 
artillery, was transferred to Versa, about four miles further 
back, as some shells had dropped in its vicinity shortly after 
it was opened. Ten beds, however, were retained in Villa 
Freifeld for sick of the headquarters staff. 

(10134) CC* 



332 MEDICAL HISTORY OF THE WAR 

A point of difficulty arose in connexion with the discharge 
of British sick and wounded to duty. According to the 
regulations of the Italian army authorities, under whose 
command the British artillery was placed, a soldier on dis- 
charge from hospital in an " infected " zone had to remain 
in a special quarantine hospital for six days before rejoining 
his unit. The zone in which the British artillery was operating 
was considered an " infected " zone, and it was necessary to 
send British sick and wounded to Italian quarantine hospitals 
for the six days before discharge. These hospitals were 
situated around Bologna, a highly malarious area, and the 
D.A.D.M.S. protested against this procedure, on the grounds 
that the soldiers ran greater risks of infection there. He 
suggested that a certificate signed by the medical officer in 
charge of the hospital from which the soldier was being 
discharged, declaring him to be free from infectious or other 
disease, should be accepted by the Italians in lieu of quarantine, 
or, as an alternative, that a convalescent camp might be 
established for British soldiers in conjunction with the Versa 
hospital, where they might be kept in quarantine for six days 
previous to discharge to their units. The Italian authorities, 
however, did not agree to this. 

Owing to the insufficient number of trained R.A.M.C. with 
the British, and the absence of any organized R.A.M.C. unit, 
a scheme was submitted to the War Office for personnel to 
form a section of a field ambulance and a casualty clearing 
station, but the increase of personnel necessary for this was 
not sanctioned and the scheme fell through. However, one 
matron and ten nursing sisters were posted to the military 
hospital at Versa in August, 1917, when the groups of bat- 
teries were increased. The number of batteries, however, 
was reduced to five in the middle of October. 

On the 24th October 1917 the Austrian offensive began, and 
lasted till the 18th November, by which date the Italian army 
had stabilized its front along the line of the Piave river. On the 
26th October the D.A.D.M.S. was warned of its being necessary 
to withdraw the hospital at Versa to a site further back. The 
nursing sisters were sent off by train to Turin that same after- 
noon, and arrangements were made to evacuate the hospital. 
The situation on the evening of the 27th had become critical, 
and during the night all patients, ten lying and seventy-eight 
sitting, were evacuated to Palmanova by eight ambulance cars, 
of which the Italians provided five, and in five Italian lorries. 
The more valuable equipment was also collected at Palmanova. 



MEDICAL SERVICES IN ITALY 



333 



Early on the 28th October notification was received that the 
patients would be entrained at 10 a.m. at San Giorgio di 
Nogaro for Turin. All but twenty- three convalescent patients 
were got away. The town was now abandoned, some houses 
were on fire, and the D.A.D.M.S., with the R.A.M.C. personnel 
and convalescents, began a march towards Codroipo. At 
San Vito a train was boarded, and all arrived safely at Treviso 
some days later, One R.A.M.C. man and three patients were 
captured at the Italian hospital at Perteole. With the exception 
of equipment and personal kits there were no other losses. 




Italian motor ambulance car and service pattern stretcher. 



On the 5th November Captain Laing, R.A.M.C, and thirty- 
five other ranks were sent to open a temporary hospital in a 
villa at Padova. Sick able to travel were transferred from this 
hospital to Turin ; others were sent to the nearest Italian 
hospital, or to the British hospital now opened at Faenza. 

On the 7th November ten guns arrived to take up positions 
on the Piave. Two medical officers were with the batteries 
and one was with group headquarters. The D.A.D.M.S. 
attached two ambulance cars to the group and formed a dressing 
station outside Treviso to which casualties were collected 
previous to their evacuation to Padova Dressings, stretchers 
and first field dressings were obtained from the Italian 
authorities. 



334 



MEDICAL HISTORY OF THE WAR 



The Britisli artillery with the Italian army was eventually 
absorbed into the British Expeditionary Force, which com- 
menced to arrive in Italv at the end of the month. 




Italian motor ambulance car. 



Medical Services with the British Expeditionary Force 

in Italy. 

When the Austrian offensive of October and November 1917 
forced the Italian troops to withdraw from their positions on 
(he Carso east of the Isonzo river to the line of the Piave, a 
British and a French expeditionary force were sent from 
France to Italy to reinforce the Italian field armies. 



MEDICAL SERVICES IN ITALY 335 

The British force consisted of the XlVth Corps, with the 
23rd, 41st and 7th Divisions, the XI th Corps, with the 5th and 
48th Divisions, and various corps, army and line of communi- 
cation troops. It absorbed, as just noted, the British artillery 
that had been operating with the Italian Third Army, and also 
the Italian section of the Mediterranean L. of C. 

Previous to the arrival of the British Expeditionary Force 
the routes of approach and lines of communication from and 
to France, and the areas which the force would occupy in Italy, 
were reconnoitred and reports were furnished on the medical 
and sanitary aspects of a campaign in Italy by Colonel F. 
Newland, then D.D.M.S. of the XVth Corps, who had been 
selected for transfer to the XlVth Corps, and by Lieut. -Colonel 
S. L. Cummins, both of whom had been specially detailed to do 
so in anticipation of the move of the troops. It was decided 
to adopt a new line of communication by the coast route from 
Marseilles to Genoa, leaving, however, the Mediterranean line of 
communication undisturbed, as it was to be used by a similar 
force of French divisions. Haltes repas, as in the case of the 
latter, were formed along the route of movement of the troops 
from Amiens through Dijon to Lyons and thence to Genoa by 
Marseilles and Ventimiglia. 

A base for the force was formed at Arquata, some twenty 
miles north of Genoa on the main line of railway to Alessandria 
and the large cities in the north-west of Italy. Lieut. -Colonel 
S. L. Cummins was then appointed A.D.M.S. of the Base, and 
Colonel F. R. Newland, with the rank of Surg.-General, D.M.S. 
of the Force. Colonel Whaite, who had replaced him as 
D.D.M.S. of the XVth Corps, was brought back to the XlVth 
Corps as its D.D.M.S. 

A General Headquarters was formed of the headquarters 
staff of the Second Army from France, and the British forces 
in Italy came thus under the command of General Sir H. 
Plumer. Lieut. -Colonel Chopping and Captain Coplans, the 
A.D.M.S. and D. A. D.M.S. (Sanitation) of the Second Army, 
remained in these appointments on the staff of the D.M.S. in 
Italy ; Surg.-General R. Porter, the D.M.S. of the Second 
Army, accompanied the staff to Italy, but was due to retire 
shortly afterwards under the age clause, and, as Surg.-General 
Newland had already been appointed D.M.S. in Italy by 
the War Office, he returned to France immediately after 
his arrival. 

The lines of communication in Italy between the front and 
the base were under an Inspector-General of Communications, 



336 MEDICAL HISTORY OF THE WAR 

Lieut. -General Sir H. M. Lawson, appointed on the 15th 
November 1917. He made Mantova his headquarters at first, 
but moved in December to Tortona, some fifteen miles north of 
Arquata and twelve miles east of Alessandria. He had no 
administrative medical staff with him at first, and Lieut.- 
Colonel Cummins acted as a D.D.M.S. of the L. of C. as well as 
A.D.M.S., Base, until the arrival of Colonel J. V. Forrest as 
D.D.M.S., L. of C, on the 24th December 1917. 

The lines of communication were then divided into two areas, 
the Base area, which included Genoa and Bordighera, and the 
Cremona area, which stretched from Mantova to Turin. The 
lines of communication command also extended to the Italian 
section of the Mediterranean L. of C, which, as shown on the 
sketch map, was also divided into two areas, the Faenza area, 
from Castellamare to Modane, and the Taranto Base area, from 
Castellamare to Taranto. 

Major C. H. Furnivall, who had been D.A.D.M.S. under 
Colonel Statham of the Italian section of the Mediterranean 
L. of C, was appointed D.A.D.M.S. to Colonel Forrest on the 
19th January, with Captain J. D. Wells as a D.A.D.M.S. for 
ambulance trains. No sanitary officer was sanctioned, however, 
for administrative sanitary duties on the lines of communication, 
and, in consequence, the headquarters of No. 110 Sanitary 
Section were transferred from Faenza to Tortona, in order that 
its commanding officer might act as sanitary officer on the 
staff of the D.D.M.S., L. of C, in addition to his other duties. 

Although numerous sanitary problems arose in connexion 
with the new line of communication areas, the appointment 
of a separate administrative sanitary officer on the staff of the 
D.D.M.S. was for some reason or other not approved. 

The field forces commenced to reach Italy early in November 
1917. The headquarters staff of the XlVth Corps arrived in 
Milan from France on the 1st of the month. They moved 
to Pavia on the 2nd and to Mantova on the 8th November. 
The 41st and 23rd Divisions were concentrating on the 17th 
November in the neighbourhood of Mantova, and moved 
on the 23rd November to a forward area in the neighbourhood 
of Vicenza, while the 7th Division was due to arrive in a 
back area between Verona and Montagnana, the latter town 
becoming railhead for the corps. The headquarters of the 
corps then moved to Lonigo, in a central position between 
Verona and Montagnana. The corps relieved the 1st Italian 
Corps on the Piave at the beginning of December. The 41st 
and 23rd Divisions went into the line on the 1st and 2nd of 



MEDICAL SERVICES IN ITALY 337 

the month from Nervesa to Ciano, about twelve miles north of 
Treviso, and some twenty-five miles north of Venice, while 
the 7th Division, on the 3rd December, relieved an Italian 
division in the reserve area. They formed part of a mixed 
British, French and Italian Force under Sir H. Plumer. 

The Xlth Corps headquarters arrived at Mantova on the 
2nd December. Its two divisions, the 5th and 48th, were to 
move to a front astride the river Brenta in the neighbourhood 
of Tezze and Marostica respectively, some twenty-four miles 
north of Padova. They formed part of a mixed Italian, 
French and British Force under General Duchesne of the 
French Tenth Army. 

The British artillery groups were attached to this corps. 

The British divisions remained in these positions throughout 
the winter, but there were no active operations. 

In March 1918 the disposition of the British divisions was 
altered. Sir H. Plumer and his staff, the Xlth Corps head- 
quarters staff and the 5th and 41st Divisions returned to 
France, and the XlVth Corps, now composed of the 7th, 23rd 
and 48th Divisions, was concentrated near Vicenza and took 
over the sector on the Asiago plateau from Sculazzon to Penna. 
Lord Cavan, who commanded the XlVth Corps, then became 
General Officer Commanding-in-Chief the British Force in 
Italy. 

The XlVth Corps as such was abolished and its headquarters 
became 1st echelon G.H.Q. of the force, with a 2nd echelon 
for directorates of administrative services at Montebello. A 
definite organization of the administrative medical services 
with G.H.p. was then authorized by the War Office, to consist 
of a D.M.Sf, D.D.M.S., A.D.M.S., D.A.D.M.S., and D.A.D.M.S.. 
(Sanitary). Colonel Whaite, who had been D.D.M.S., of the 
XlVth Corps, remained as D.D.M.S. with the 1st echelon, 
representing there Surg.-General Newland, the D.M.S., who 
established his office at Vicenza. A D.A.D.M.S. was added to 
the staff to assist Colonel Whaite. 

The new front on the Asia.go plateau was at first held by 
the 23rd and 7th Divisions with the 48th in reserve. In May 
the 11th Italian Division was added to the force on the Asiago 
plateau under Lord Cavan. 

Outline of the Operations. 

The Asiago front was attacked by the enemy on the 15th 
June 1918, but the British casualties were comparatively slight. 
This was followed by a raid on the enemy trenches by British 

(10134) dd 



338 MEDICAL HISTORY OF THE WAR 

divisions on the 9th August, during which one of the R.A.M.C. 
officers, Captain W. H. Lister, was killed. The 23rd and 
48th Divisions again raided the enemy's trenches on the 
27th August, and two more raids were made on the 10th 
September. 

At the end of September the 23rd and 7th Divisions were 
withdrawn from the Asiago front, leaving only the 48th Division 
in line there. The two former divisions moved in the middle 
of October to an area south of Treviso and west of the Treviso- 
Venice road, and went into line on the Piave in front of Treviso. 
The XlVth Corps then came into being again with Colonel 
Whaite as its D.D.M.S., while Lord Cavan assumed command 
of the Tenth Italian Army, which now included the British 
XlVth Corps. The 48th Division, however, remained under 
the Italian command on the Asiago front. Lord Cavan's 
army, in conjunction with the Third Italian Army on its right 
and the Eighth Italian Army on its left, attacked the enemy 
on the Piave front between the 23rd October and 4th November 
1918. The 7th and 23rd British Divisions were engaged. The 
48th Division was also engaged between the 29th October and 
4th November on the Asiago front. The operations were 
continued by the British divisions in association with the 
Italian and French divisions both on the Piave and the Asiago 
front until hostilities ceased on the 4th November. 

The British divisions then were withdrawn from their front 
lines and concentrated in an area west of Vicenza by the 
middle of November. Detachments were sent on the 22nd 
November 1918 to Fiume and on the 28th November to the 
neighbourhood of Innsbruck. 

Demobilization commenced in December. A medical 
mission of a detachment of the 1/lst South Midland Field 
Ambulance was sent to Austria. The D.M.S., Surg.-General 
Newland, remained in Italy till the end of February 1919, 
directing the work of the demobilization of the medical services. 



The Medical Arrangements. 

When the British divisions commenced to arrive in Italy, 
much difficulty was experienced in obtaining suitable positions 
for the casualty clearing stations, and for establishing a line 
of evacuation from them to the base. There was no difficulty, 
however, in obtaining suitable buildings and accommodation 
for the base hospitals on the lines of communication at Genoa 
and Bordighera. Cremona was considered the most suitable 



MEDICAL SERVICES IN ITALY 339 

position for an advanced hospital centre, similar to the hospital 
centre established at St. Omer in France. It was on the line 
of the British retreat in the event of the enemy breaking 
through, and it was felt that should heavy casualties occur, 
its position would shorten the journey of ambulance trains to 
and from the front, as wounded could be unloaded there 
while base hospitals were being cleared to France. It was 
also sufficiently near the front to allow of motor ambulance 
convoys taking wounded there direct from the field ambulances 
in the event of casualty clearing stations being obliged to 
close and retire. 

Some opposition was made to the British establishing hospitals 
in Cremona, but the difficulties were overcome, and No. 29 
Stationary Hospital from Salonika was in full working order 
there, with accommodation for 600. by the beginning of Decem- 
ber. No. 30 Stationary Hospital from Salonika was also 
opened at Cremona shortly afterwards. At the same time 
No. 11 General Hospital and No. 38 Stationary Hospital from 
France were established in Genoa, and Nos. 62 and 66 General 
Hospitals from Salonika in Bordighera. No. 51 Stationary 
Hospital, which mobilized in Malta, did not come to Italy 
until the beginning of 1918. It was divided into three sections, 
two were opened at Genoa, one for local sick and another for 
infectious diseases, and the third section acted as a station 
hospital at Arquata, the base headquarters. 

A convalescent depot, mobilized at Rouen, was also sent 
to Arquata at the end of November, but it was transferred to 
Genoa in January. 

At Marseilles No. 57 General Hospital from Boulogne, 
No. 81 from Malta, and a convalescent depot were opened at 
the end of 1917 and beginning of 1918 for the reception of sick 
and wounded evacuated from Italy. 

A line of communication was thus established, with the main 
hospital centres at Genoa and Bordighera receiving casualties 
from front areas through Cremona and evacuating them to 
Marseilles. This arrangement held good throughout the 
occupation of an Italian front by British troops, the only changes 
being the return of No. 66 General Hospital to Salonika in 
April 1918, and the acquisition of the Becket Red Cross 
Hospital in Turin by the British military authorities in the 
same month. No. 66 was not replaced, but No. 62 General 
Hospital was expanded by taking over its site and equipment, 
so that there was no loss of hospital beds. The Turin hospital 
became a section of No. 29 Stationary Hospital at Cremona. 



340 MEDICAL HISTORY OF THE WAR 

The selection of strategical positions for the casualty clearing 
stations proved difficult at first, and some anxiety was felt 
lest suitable arrangements should not be ready if the enemy 
made a determined attempt to break through immediately 
after the line on the Piave and Brenta had been taken up by 
the XlVth and Xlth Corps. 

During the period of concentration, Nos. 9 and 38 C.C.Ss. 
were opened in buildings at Canneto and in a hospital at 
Mantova, respectively ; but. they were sent to Montagnana, 
the railhead of the XlVth Corps, midway between Padova 
and Mantova, and opened there between the 25th and 29th 
November. 

Nos. 24 and 39 C.C.Ss., on arrival in Italy, remained parked 
at Citadella, on the railway line between Vicenza and Treviso, 
ready to move forward when the British troops took over a 
front line. Istrana, some twelve miles west of Treviso, was then 
selected as the best strategical position for casualty clearing 
stations, and Nos. 24 and 39 C.C.Ss. were placed there early in 
December. 

The fifth casualty clearing station, No. 37, came to Italy 
in the beginning of December and went to Padova, where it 
opened in a hospital building, but, as the Italian authorities 
were desirous of removing medical units from the city, it 
was transferred in January to a villa, about two miles south 
of Padova, where it remained until its return to France in 
April 1918. 

This disposition of casualty clearing stations was suitable 
for operations on the Piave front, but did not satisfy the 
requirements of the divisions on the Brenta. Consequently 
Nos. 38 and 9 C.C.Ss. were removed from Montagnana in 
January, the former to Barina, on the left bank of the Brenta, 
just west of Citadella, where it opened under canvas, and the 
latter to Cavazzale. Until they were ready, sick and wounded 
of the Xlth Corps were sent to No. 37 CCS. at Padova. 

The accommodation in No. 38 CCS. at Barina was for 250 
only in marquees, but a number of huts was to be sent there 
for this casualty clearing station by the Italian authorities. 
The marquees, owing to the intense cold of January and to 
the lack of coal, were far from comfortable. They were heated 
by oil stoves, and patients were retained in them as short a 
time as possible, evacuation being arranged to take place by 
ambulance trains every second or third day. The huts arrived 
on the 14th January, but, owing to the projected move of the 
Xlth Corps from the Brenta positions to a position at Arcade 



MAP OF POSITIONS OF CASUALTY CLEARING STATIONS QN THE ITALIAN FRONT. 




50 Miles 



CCS. positions during the occupation of 
the. Montello Front February 1917. 
CCS, positions during the occupation oF 
the Asiago Front (May -Sept. 1918) 

CCS. positions during the Fistal operat 
oF October -November 1918. 

im * Approx. Front Line Summer & Autumn 1918. 



jiConeqliano M ^^r d D |V 
British XtV Corps position / * Jr 00 

>^_ December 1917, J ^P 



Caste/fr 



^ Camposampiero 




Montebelluna 



s £fy Mardilay 



Montebello 

o 



Mirano 
N? 
39 



) Lonigo 



Montagnana 




yENlCE 



GULF 

OF 
VENICE 



Malby*Sons.Lith. 



MEDICAL SERVICES IN ITALY 341 

on the right of the XlVth Corps on the Piave, they were 
not erected at Barina. No. 38 CCS. moved at the end of 
the month to Paese, half-way between Istrana and Treviso. 
No. 9 CCS. was also moved from Cavazzale to Paese at the 
same time. 

The positions of the casualty clearing stations consequently 
at the beginning of February were as shown on the sketch 
map. 

When the Xlth Corps was withdrawn from Italy Nos. 38 
and 37 C.C.Ss. returned to France with it, and the remaining 
casualty clearing stations were then moved to positions behind 
the new front on the Asiago plateau. 

Nos. 24 and 39 C.C.Ss. were opened at Montecchio-Precalcino 
and No. 9 at Dueville. Both of these positions are close together 
about seven miles north of Vicenza, and between eighteen to 
twenty miles from the front line. They were on the plains, 
just south of the mountainous region leading to the Asiago 
plateau. 

The positions of the three casualty clearing stations then 
remained unchanged until just before the final offensive on the 
Piave at the end of October, when the 7th and 23rd Divisions 
returned to the Piave front. No. 39 C CS. was then moved to 
Mirano, six miles west of Mestre, and No. 9 to Martellago, 
some six miles north-west of Mestre. Both of these towns 
were some twenty miles distant from the Piave front, but 
advanced operating centres were thrown out close behind the 
line. No. 24 CCS. remained at Montecchio-Precalcino for the 
reception of casualties from the 48th Division, which remained 
on the Asiago front. 

After hostilities had ceased No. 9 CCS. returned to Dueville 
and No. 39 was withdrawn to Vicenza, so that at the end of 
1918 the distribution of the casualty clearing stations was : — 

At Dueville No. 9. 

At Montecchio-Precalcino . . . . No. 24. 
At Vicenza No. 39. 

The advanced depots of medical stores were No. 32 from 
France and Nos. 35 and 36 from England. No. 35 had arrived 
in August and went to Taranto, where it remained. No. 32 
was opened at Montagnana at the end of November 1917, but 
in February 1918 it was sent to Camposampiero, a railway 
junction eighteen miles north of Padova, and at the end of 
April to Vicenza, where it remained till the end of the year. 
No. 36 Advanced Depot was at Istrana from December 1917 to 
April 1918, when it moved to Thiene, behind the Asiago front 



342 MEDICAL HISTORY OF THE WAR 

and eighteen miles north of Vicenza. At the end of October it 
was transferred to the Piave front and opened at Treviso. 

The Base Depot of Medical Stores, No. 14, was a new unit 
from England. It arrived in Genoa on the 1st December 1917 
and remained there. 

Of the four mobile laboratories allotted 1 to the British force, 
all of which came from France, No. 7 (Bacteriological) and 
No. 15 (Hygiene) accompanied the casualty clearing stations, 
while No. 14 (Bacteriological) and No. 23 (Hygiene) were 
placed at Genoa and Cremona respectively. 

Three motor ambulance convoys accompanied the British 
force to Italy, two from France, Nos. 26 and 36, and one, 
No. 41, from England. A fourth convoy, No. 42, had been 
prepared in England for Italy and was to have been sent there 
in the latter part of February, but owing to the reduction of the 
divisions there and the military situation on the Western Front 
it was retained in France. No. 26 M.A.C. was placed at the 
disposal of the XlVth Corps. No. 36 went to the Xlth Corps, 
but for a time had a section detached for duty at the base, 
where it was assisted at the end of 1917 by twenty cars from 
the British Red Cross Society. No. 41 M.A.C. did not arrive 
till towards the end of January 1918. It was retained as a 
G.H.Q. reserve. 

The work of the motor ambulance convoys and the motor 
ambulance cars of the field' ambulances was affected by the 
move of the British line to the Asiago plateau, where the country 
was Alpine in character. The roads in places had hairpin 
bends and steep gradients and were in places dangerous. 
Light vehicles were the most suitable, but most of the cars 
were too heavy for the work. Some, however, could negotiate 
the bends, but much trouble was caused by overheating of the 
engines during climbing. In view, consequently, of the neces- 
sity of depending largely on pack transport, a reorganization of 
the transport of the field ambulances became necessary, and 
experiments as to the most suitable form of ambulance car 
were conducted by .Colonel Blackham, the A.D.M.S. of the 
23rd Division. The Ford cars were brought to the plateau and 
remained there. For work on the mountain roads back from 
the plateau the motor ambulance cars with the less powerful 
engines were exchanged for those with greater power and large 
radiators. The Italian Fiat cars were the best for this purpose, 
and authority was received from the War Office for the purchase 
of fifty Fiat cars with a body similar to that used in the hills 
by the Italians. The body was of thin metal, with doors at the 



MEDICAL SITUATION IN THE BRITISH XIV COR PS ON THE ASIACO FRONT IN JUNE 1918. 

\Asiago 



+ Regmntl. Aid Post. 
• Ambulance CarColleciing Post. 
Q Advanced Dressing Station. 

S Main Dressing Station. 
£± Corps Walking Wounded. 

Co//ecting Post. 
*)L Advanced Operative. Centre 
Motor Ambulance. Convoy 
__ Approximate Front Line 
Div/sional Boundaries . 




Conco 



Sa/cedo 



MaJbyASons.Lith 



MEDICAL SERVICES IN ITALY 



343 



back, and carried six lying-down patients. The authority to form 
a convoy with Fiat cars was not received, however, till October, 
and the convoy had not been formed when hostilities ceased. 

Considerable dislocation of the motor ambulance convoys 
took place in order to exchange their more powerful cars with 
the less powerful cars of the field ambulances, on which most 
of the hill work was thrown. Consequently, No. 26 M.A.C. was 
withdrawn to Genoa in April 1918, where it remained working 
at the base until the end of the year. No. 41 also was sent to 
Genoa during the greater part of the time when the Asiago 
plateau was held by the British, leaving No. 36, with the more 
suitable cars, as the one convoy working in the forward area. 
No. 41 returned to the forward area, with its headquarters 
at Thiene, at the end of July. During the October operations 
No. 36 worked on the Piave front and No. 41 on the Asiago front. 

The Austrian Offensive of ISth to 24th June. 

The Austrian offensive in the summer of 1918 was launched 
on a front of some ninety miles from the river Astico to the sea. 
The British forces were engaged on the 15th and 16th June, 
mainly on the Asiago plateau, north of the line Conco-Congollo. 
The 23rd and 48th Divisions were holding this position, with 
the 7th Division in reserve. Although the enemy penetrated 
the 48th Division front to a depth of about 1,000 yards on the 
15th June, counter-attacks were delivered in the evening, and 
on the following day the original line was restored. Raids 
were made by troops of the 23rd Division on the night of 
the 21st/22nd June, and normal conditions existed on the 
British front by the 24th June. 

The weather on the 15th June was warm and sunny. 

The casualties admitted to the casualty clearing stations and 
evacuated from them during these operations were as follows : — 



Date. 


Admitted. 


Evacuated. 


Sick. 


Wounded. 


Sick. 


Wounded. 


15th-16th 


349 


864 


89 


802 


16th-17th 








302 


204 


58 


176 


17th-18th 








314 


48 


43 


65 


18th- 19th 








277 


15 


85 


10 


19th-20th 






. 


226 


8 


156 


9 


20th-21st 


. 






240 


5 


163 


3 


21st-22nd 






. 


208 


39 


62 


36 


22nd-23rd 








198 


9 


107 


7 


23rd-24th 








210 


— 


79 




Total 


2,324 


1,192 


842 


1,108 



344 MEDICAL HISTORY OF THE WAR 

The large number of sick was due to an outbreak of 
influenza at the time. 

The enemy used a considerable number of lachrymatory and 
cyanogen bromide gas shells, but the casualties from these 
were comparatively few. 

As compared with the battles on the Western Front, therefore, 
the work of the medical units was easy, but they had to contend 
with the difficulties inherent in operations in mountainous 
country. 

The 23rd Division A.D.M.S., Colonel W. Croly, had organ- 
ized his field ambulances to work on two sectors, right and left. 
The right sector had two regimental aid posts, clearing by hand 
carriage to a divisional collecting post on the San Sisto road, 
and thence by motor ambulance car to an advanced dressing 
station at Pria dell'Acqua. The left sector had also two 
regimental aid posts, with hand carriage to a collecting post, 
and motor ambulance transport thence to an advanced dressing 
station at Capitello. The regimental aid posts were in a cave 
and in Italian dugouts. There was no congestion in them at 
any time ; but the roads from them and from the collecting 
posts were rendered impassable to wheeled transport by the 
heavy barrages and by fallen trees. The wounded had conse- 
quently to be carried by hand for a considerable distance to the 
Val del Barenthal road on the right and to bearer posts on a. 
new line on the left. The road to Capitello was, however, 
cleared and repaired by the afternoon of the 15th and the 
original line of evacuation restored. 

The advanced dressing stations were heavily shelled on the 
morning of the 15th June, but at no time was there any delay 
in clearing the wounded. 

The main dressing station was at Granezza. The walking 
wounded continued to arrive at it up till noon, and after 
that hour the stretcher cases came in steadily. In the afternoon 
there was some congestion at Granezza, owing mainly to an 
insufficient number of motor ambulance convoy cars coming 
up, but evacuation proceeded normally when a circuit of cars 
had been established. Granezza was heavily shelled during the 
morning of the 15th June. It was a crowded locality, and the 
D.M.S. instructed the A.D.M.S. on the 19th June to seek a 
more suitable place for his main dressing station.* 

There were some casualties amongst the R.A.M.C. of the 
division, one man of No. 70 Field Ambulance being killed 

* In August a new dressing station was opened in seven Italian huts at 
Case di Mazze, in place of Granezza. 



MedicalSituation in the 48 th Division During 
the Austrian offensive of 15 th Junb 1918 



AovAkNceo 
Dressing 3tatiqn 



^Reqimental 
M/0 Post 



Bearer or 
Relay Post 




MEDICAL SERVICES IN ITALY 



345 



and one dying of wounds. An officer, Captain R. Craig, 
in medical charge of the 11th Northumberland Fusiliers, 
and nine men of the field ambulances were wounded. 

Amongst the wounded collected by No. 70 Field Ambulance 
there were 144 Austrian and 12 Italian wounded, 122 of the 
former and 7 of the latter being stretcher cases. 

The 48th division A.D.M.S., Colonel Pickard, established 
right and left lines of evacuation from the regimental aid 
posts to a main dressing station at Casa di Sunio. On the 




Main dressing station at Casa di Sunio. 



right, wounded were brought back by hand from two regi- 
mental aid posts to an advanced dressing station at Boscon ; 
thence by motor ambulance cars to Casa di Sunio. On the 
left, the regimental aid posts were cleared to Cesuna either 
by hand or by Ford cars from Cavrari. At Cesuna they were 
transferred to the heavier cars and taken through Casa 
Magnaboschi to the main dressing station. When the enemy 
penetrated the line, the regimental aid posts in the centre 
were withdrawn, the more seriously wounded having to be 
left behind in the retirement, while the regimental aid posts 
on the right and left held their positions. The road from 



(10134) 



EE 



346 



MEDICAL HISTORY OF THE WAR 



the advanced dressing station at Boscon was destroyed at 
one place and a large artillery dump exploded, interrupting 
traffic for some three hours. The advanced dressing station 
consequently had to be kept clear by hand carriage, but no 
congestion occurred, reinforcements of bearers being sent up 
from time to time. The road was sufficiently repaired for 
cars to go up to Boscon advanced dressing station by 10 a.m. 
on the 16th June 




" Swiss Cottage." Advanced dressing station at Boscon, Asiago Front 1918. 

The division had to deal with a large number of sick, owing 
to the influenza epidemic. The empty returning lorries were 
used to evacuate them. On the second day many Austrian 
wounded had been left behind in the counter-attack. They 
were also sent back in lorries to the casualty clearing station. 

The sketch maps of the front positions of the medical 
posts of the 48th Division show how they were affected 
by the penetration of the line by the enemy on the morning 
of 15th June. 

The casualty clearing stations, as already noted, were at 
Montecchio-Precalcino (Nos. 24 and 39) and at Dueville 
(No. 9). No 36 M.A.C. was employed in clearing to them. 
Its headquarters were at Madonetta. 




MEDICAL SERVICES IN ITALY 



347 




348 MEDICAL HISTORY OF THE WAR 

One of the field ambulances of the 1th Division in reserve, 
No. 21, formed a walking wounded collecting station for the 
23rd and 48th Divisions in school buildings at Calvene. The 
other field ambulances of the division were employed as a 
divisional rest station and hospital for sick, but a section of 
No. 22 was employed in an advanced operating centre at 
Cavaletto. 

A convalescent camp for influenza cases was established 
by the 48th Division field ambulances at Tavola (Madonetta) 
and a scabies hospital and divisional rest station at Grumolo 
Pedemonte. The 23rd Division had a divisional rest station 
at Salcedo. 

The Battle of Vittorio Veneto. 
The Passage of the Piave. 
(23rd October to 4th November 1918.) 

During the final operations on the Italian front the British 
divisions, as already noted, were engaged on two sectors ; 
the 7th and 23rd Divisions in the Italian Tenth Army, under 
Lord C avan, on the Piave, east of the Treviso-Conegliano 
railway ; and the 48th Division on the Asiago front and in 
the Val d'Assa, to the north-west of Asiago. 

The operations conducted by the former two divisions 
were the Passage of the Piave, and by the latter division the 
fighting in the Val d'Assa. 

In the operations, which commenced on the Piave on the 
night of the 23rd/24th October and culminated in the armistice 
with Austria on the 4th November, the 7th Division was on the 
British right and the 23rd Division on its left, on the right 
bank of the river facing the island, Grave di Papadopoli. 

The first phase of the attack was the capture of the island 
by a brigade of the 7th Division and a battalion of the 23rd 
Division on the night of the 23rd/24th October. The troops 
crossed over by boats and bridges to the Lido, or northern 
end of the island, captured the island and many prisoners, 
and then withdrew to their original positions, leaving a holding 
party on the island. The main attack was to take place on 
the following night, but it rained heavily during the 24th and 
the river rose. The operations were consequently postponed 
till the morning of the 27th October. Both divisions crossed 
to the left bank that day and advanced between then and the 
1st November to the Monticano and Livenza rivers. The 
23rd Division then remained in the area around Sacile on the 






MEDICAL SERVICES IN ITALY 



349 



Livenza, while the 7th Division advanced to the Tagliamento, 
an Italian division having taken its place on the right of the 
23rd Division. 



The Medical Services during the Passage of the Piave. 

At the commencement of the battle the 7th Division had 
an advanced dressing station at Maserada and the 23rd at 
Lovadina. A corps lightly wounded dressing station was 




Ward in an advanced operating centre in Italy. 



opened at Limbraga, on the main road north of Treviso, and 
an advanced operating centre, with teams from Nos. 9 and 
39 C.CSs., somewhat further forward at Carita, on the same 
road No. 9 CCS. was opened at Martellago for wounded 
only and No. 39 CCS. for influenza patients and other sick. 
Field ambulance motor cars evacuated casualties to the ad- 
vanced operating centre and lightly wounded dressing station, 
and No. 36 M.A.C cleared these to the casualty clearing 
station. No. 36 Advanced Depot of Medical Stores was then 
at Thiene. Dumps of stretchers and blankets were kept at 
Limbraga, and also at the advanced dressing station. 



350 



MEDICAL HISTORY OF THE WAR 



The field ambulances of both the 7th and 23rd Divisions had 
been divided into " A " and " B " echelons. Their transport 
had been reorganized for work in the mountains on the Asiago 
front, as already noted, and had pack transport, G.S. and light 
(cavalry pattern) horsed ambulance wagons added to it. "A" 
echelon was consequently formed of the bearer divisions with 
one tent sub-division each and the light transport ; " B " 
echelon of the remainder of the units and the heavy transport. 




Operating theatre at an advanced operating centre in Italy. 



During the initial operation by the 7th Division on the 
night of the 23rd/24th October, a small detachment of "A" 
echelon of No. 22 Field Ambulance, consisting of a bearer 
sub-division and two medical officers, each bearer taking with 
him a stretcher, a blanket and a quantity of surgical dressings, 
crossed to the island in boats with the brigade. The crossing 
was difficult owing to the darkness. The boats held only 
seven men each and the current was strong. The casualties 
were few and were successfully got back to the mainland in the 
empty boats. They were transferred in ambulance cars to the 
23rd Division advanced dressing station at Lovadina. In spite 
of the heavy shelling there were no casualties during the 



MEDICAL SERVICES IN ITALY 351 

transit. The detachment left on the island was in danger of 
being cut off from supplies when the river rose in flood the next 
day, but extra rations and medical supplies, stretchers and 
blankets were got across. 

During the main operations, collecting posts were formed by 
both divisions on the left bank of the Piave, and the advanced 
dressing stations followed in echelons the advance of the 
brigades. None of the wheeled transport, however, could be got 
across until later, when only the light horsed ambulance 
wagons and Ford ambulance cars arrived on the left bank. 
They were not, however, permitted to return loaded across the 
river. Consequently for a time the evacuation of wounded had 
to be carried on by relays of stretcher bearers with the aid of 
wheeled stretcher carriers. Both divisions had reinforced the 
number of stretcher bearers by 150 men from the infantry and 
divisional employment companies, and twenty mule leaders 
were attached to each field ambulance for the pack transport. 

For the first three days after crossing the Piave it was found 
extremely difficult to maintain an adequate supply of stretchers 
and blankets. The position was relieved when the Ford 
motor ambulance cars crossed the river, but there was no other 
source of supply until Sacile was reached. Then a large 
quantity of dressings was found there in the hospitals aban- 
doned by the Austrians.* 

As the Italian division moved into the area of the 7th 
Division, orders were given to the A.D.M.S. of the latter on the 
morning of the 28th October to take its wounded into his 
advanced dressing stations. They were to be evacuated from 
there in Italian ambulance cars, but, as only three cars arrived, 
most of the evacuation of Italian wounded to their own hospitals 
was carried out by the British ambulance cars. A large number 
of Austrian wounded was also collected and evacuated 

The steadily increasing distance from the river bank made 
evacuation by wheeled traffic more and more urgent The 
light horsed ambulance wagons came over first, and relieved 
the situation to some extent ; but it was only when the motor 
ambulance cars reached the left bank of the river that material 
assistance was obtained. Fortunately the casualties were not 
excessive, and Austrian prisoners assisted in the work of carry- 
ing them back. The assistance of the Austrian prisoners, 

* No. 36 Advanced Depot of Medical Stores had not arrived at Treviso until 
the 30th October, and motor ambulance cars had to be sent back to Thiene 
and Vicenza to obtain supplies, thus using up ambulance transport required 
for evacuating wounded to the casualty clearing stations near Mestre. 



352 



MEDICAL HISTORY OF THE WAR 



however, led to difficulty in obtaining stretchers, as the prisoners 
did not return, and the stretchers taken back by them did not 
again come up, at any rate immediately. 

Large numbers of bearers had to be kept constantly on duty 
carrying wounded across the river by hand. In carrying 
from the left bank to the island the bearers had to wade at 
times waist deep. The general system of evacuation from the 
collecting posts in the most advanced situations to the advanced 
dressing station at Lovadina on the right bank of the Piave 
is well illustrated by the sketch map taken from the diary of 
Colonel W. G. Wright, the A.D.M.S. of the 23rd Division, and 
the system of hand carriage across the Piave to the advanced 
dressing station at Maserada by a similar sketch map from the 
diary of the A.D.MS, of the 7th Division, Colonel S. A. Archer. 

Medical Situation of the 23 r -° Division during the final 

OPERATIONS ON THE PlAVE,OcT. 1918. 



Conegliano. 




n Ma/w Dressja/gStat/om or 

" /te»^««4?Tifi»S oe-/\A. 
O AOVAWCEO £>RESS/A/G STA. 
• CoLLECT/NG &OST. 

*- Searer relay posy. 

Method of Evacuation. 



Ma/vo Carriage. 
• Haa/o carr/age &> 

horse aafecjla/vces. 
L/ghtcars *t Morse ames 
>H£AVV ameuljwce cars. 



OF MILES. 
3 4- 5 

— I 1 »- 



MEDICAL SERVICES IN ITALY 353 

Until Sacile was occupied by medical units there were no 
suitable means of retaining wounded in the area east of the 
Piave, and all had to be transferred to the area west of the 
river, but by the 31st October a main dressing station and 
advanced operating centre were opened at Borgo Villa, where 
there had been an Austrian medical post with ample accom- 
modation, by No. 71 Field Ambulance and No. 9 CCS., and 
on the 2nd November an advanced operating centre of No. 39 
CCS. was moved into the Austrian hospital in the elementary 
school at Sacile.* 

At the time of the armistice the D.M.S. had arranged with 
the D.D.M.S., XlVth Corps to assume responsibility for the 
evacuation of casualties from the left bank of the Piave, and 
100 Austrian prisoners, under the direction of two officers and 
several N.COs. of the R.A.M.C, were employed in this duty. 
The casualties could only be evacuated from the left to the right 
bank by hand carriage throughout the operations, and this, as 
already shown, was effected by relays of bearers. The distance 
across the river by the Salettuol Bridge was two miles. An 
advanced section of No. 9 CCS. was at Lovadina on the 4th 
November, and the evacuation across the river was placed 
under the direction of its commanding officer. The ambulance 
cars were not allowed to return across the pontoon bridges 
till the 6th November. The relays of bearers were then 
withdrawn. 

The situation, therefore, at the time of the armistice showed 
the field ambulances of the 7th Division in the Tagliamento 
area, those of the 23rd Division in the Livenza area, advanced 
sections of No. 39 CCS. at Sacile and of No. 9 CCS. at 
Lovadina, with advanced operating centres at Sacile, Borgo 
Villa and Carita, and their headquarters still far back in the 
vicinity of Mestre. Evacuation to the base was taking place by 
ambulance train from Mestre. No. 36 Advanced Depot of 
Medical Stores was at Treviso, and No. 36 M.A.C was engaged 
in evacuating casualties from the right bank of the Piave to the 
casualty clearing stations and ambulance trains. 

On the 9th November the British divisions commenced to 
withdraw to the areas around Vicenza. 



* There were three Austrian hospitals in Sacile. They had been left intact. 
In one, the civil hospital, there were many cases of typhoid fever and influenza. 
The elementary school had been used as an operating centre. Only unburied 
dead had been left in it. In the third there were a number of Austrian and 
one British wounded and influenza cases, under the charge of an Austrian 
medical officer and two sisters. None of the hospitals, however, had food or 
comforts, and the rest of the staffs of all had been withdrawn. 

(10134) FF 



354 



MEDICAL HISTORY OF THE WAR 



The total number of casualties admitted to the medical units 
of the XlVth Corps between the 26th October and 1st November 
was 2,518, distributed as shown in the following table : — 



Formations. 


Advanced Operat- 
ing Centres. 


Lightly Wounded 
Dressing Stations. 


Grand 
Total. 




Offs. 


O.R. 


Total. 


Offs. 


O.R. 


Total. 


7th Division 
23rd Division 
Other formations 
Italians 
Austrians 


6 
6 
2 
1 
13 


Ill 

122 

4 

45 

89 


117 

128 

6 

46 

102 


5 
20 

7 

13 


392 
607 
9 
608 
458 


397 
627 
16 
608 
471 


514 
755 
22 
654 
573 


Totals 


28 


371 


399 


45 


2,074 


2,119 


2,518 



The Fighting in the Val d'Assa. 
(29th October to 4th November 1918.) 

The operations in which the 48th Division was engaged 
while the 7th and 23rd Divisions were thus advancing across 
the Piave to the Tagliamento commenced in the Asiago area 
with a bombardment of the enemy trenches and a raid by a 
battalion in the early morning of the 29th October. The 
trenches were found empty, the enemy apparently having 
withdrawn to the north of Asiago. The divisional front then 
advanced to Camporovere, and attacked the hills north of 
Asiago on the east of the Val d'Assa, on the morning of the 
1st November. The enemy retired during the night of lst/2nd 
November to the Val d'Assa, and an advance along the Val 
d'Assa was ordered, with advanced guards occupying the hills on 
either side. On the morning of the 3rd November an enemy 
corps headquarters and portions of two divisions were sur- 
rounded near Vezzena in the valley and over 7,000 prisoners 
taken. The 48th Division then occupied the towns of Caldonazzo 
and Levico in the Val Sugana (on the Brenta river), and the 
armistice was signed the following day. The division was 
withdrawn to the plains on the 10th November. 

The general arrangements for the medical services were 
similar to those during the fighting on the Asiago front in June 
1918. The wounded were few, but there were many sick. 

No. 24 CCS. remained at Montecchio-Precalcino in the 
plains, and had a detachment forming an advanced operating 
centre at Cavalletto on the plateau. An advanced dressing 
station was at San Sisto and the main dressing station at 



MEDICAL SERVICES IN ITALY 



355 



Mazze, to which it had been withdrawn from Granezza after 
the operations in June. The regimental aid posts remained 
along the line Camporovere to Asiago until the 2nd November. 
When the division advanced along the Val d'Assa on that 




day, an advanced dressing station was opened by the l/2nd 
South Midland Field Ambulance in an admirably equipped 
Austrian medical unit in the valley, and another post was 
opened by the l/3rd South Midland Field Ambulance at Asiago. 



356 MEDICAL HISTORY OF THE WAR 

On the 3rd November the main dressing station was moved up 
to the position of the advanced dressing station in the valley, 
and the advanced dressing station moved forward to an 
Austrian bakery near Vezzena. When the armistice was signed 
the A.D.M.S. of the division went on to Caldonazzo and took 
over an Austrian hospital, which had accommodation for about 
150 on beds or mattresses in two large buildings. The l/2nd 
South Midland Field Ambulance was then ordered up to it. 
Afterwards sick and wounded were collected to Caldonazzo. 
They were all cleared to No. 24 CCS. at Montecchio-Precalcino 
by the 14th November. On the 16th November the A.D.M.S. 
of the 48th Division was sent to Innsbruck in search of British 
sick and wounded prisoners of war. He returned on the 23rd 
November with twelve. 



The Lines of Communication. 

The organization of the lines of communication from the 
British front in Italy to the base hospitals at Genoa and 
Bordighera, and thence to the Marseilles base in France, has 
already been described. No material changes were made during 
the time the British forces were in Italy. But before the 
organization had been built up and the hospital units from 
France and Salonika arrived, the officer commanding No. 79 
General Hospital at Taranto was directed to send the equip- 
ment for 500 beds with such personnel as could be spared to 
Arquata. A hospital for 200 beds was rapidly organized there 
in a disused wine factory with this equipment and was known 
as the Station Hospital, Arquata, until it was taken over as 
" B " section of No. 51 Stationary Hospital. Officers and men 
of the R.A.M.C who had been attached to the groups of artillery 
were at the same time employed in forming medical and sanitary 
posts along the route by which the troops were arriving in 
Italy. At Ventimiglia, for example, they established a small 
detention hospital, and at Savona a large halte repas. 

A consulting surgeon, Colonel T. Crisp English, and a 
consulting physician, Colonel H. H. Tooth, were appointed 
for duty on the lines of communication and took up their head- 
quarters at Genoa. The former left in June and the latter 
in October 1918. Colonel English was not replaced, but 
Colonel G. R. Murray replaced Colonel Tooth. On the D.M.S. 
staff there were also a consulting surgeon, Colonel Gordon 
Watson, who came with the staff of the Second Army from 
France, and a consulting physician, Lieut. -Colonel Gates. 



MEDICAL SERVICES IN ITALY 



357 



The hospital accommodation at Marseilles and number of beds 
occupied at the end of each month are shown on the chart. 



CHART SHOWING THE NUMBER. OF HOSPITAL B E1DS AT MARSEILLES BASE 
FOR THE BRITISH FORCES IN ITALY 

TOP LINE = TOTAL NUMBER OF BED* BOTTOM LINE = NUMBER OF OCCUPIED BEDS 
SHABEtl PORTION = VAf.AIMT BEOS 


NUMBER 

Of BEOS 




NUMBER 
OF BEOS 


SO 00 
£000 
1000 




3000 
2000 
1000 
















































































































^r 


















































s 
























































i 


cr* 


























































































































































- 






























































































' 1 




































































































































U 1 t " 






























~ 












! 


























































































- 




































1 j 
1 j 

I 




'_ 


























: 






-■ 


r^ 
























L 












-T^ 


















1 i 
1 i 

1 ' 

1 








i 


L- 


r-H 




^ 






1 

i I 
. . .1. , . .i. . . . 




. . . .1. . . . 








< II IB 25 

DEC. 
19/7 


IT 14 21 28 
JAN. 

(918 


4 II I8 2j|4 II 18 25 
FEB. | MARCH 


J IS 22 2? 4 U20 27|jl0n24 
APR.| MAY I JUNE 


1 8 15 22 21 
JULY 


5 1219 26b? 16 23307 14 21 21 
AUG. 1 SEPT. | OCT. 


4 II (8 2^26 
NOV. \DEC 



Accommodation at the base in Italy was organized on the 
same lines as in France, that is to say, expansion in emergency 
was provided for by crisis accommodation, and beds were set 
apart for special diseases, and for officers, nursing sisters and 
labour units, as shown on the next page. 

General service V.A.D. women were employed in the hospitals 
after August 1918. Before then authority was obtained for 
the employment of Italian women. Women drivers from 
England were employed at the base for motor ambulance 
cars. Hostels were opened for nursing sisters at Taranto, 
Rome, Turin and Genoa, more especially for nursing sisters 
passing to and from Salonika. A convalescent home was 
also established for them at first in Turin, but towards the 
end of 1918 in a villa at San Remo. The convalescent home 
at Turin was then appropriated for general service members 
of the V.A.D. 

In July 1918 the Kulm Hotel at Portofino, near Genoa, 
was acquired as a convalescent home for officers. It had 
accommodation for sixty-eight. Previous to this an American 
citizen, Mr. Hagemeyer, offered accommodation for four 
officers in his house at Florence. It was used mainly by 
officers who had been left sick at Faenza on their way to or 
from Taranto. 



358 



MEDICAL HISTORY OF THE WAR 



CO 



CO 

I 



fr 

« 
s 



o 

"3 

CO 

S 

I 

o 

co 
8 



8 

o 

to 
« 

co 1 

•8 






I 



* 


tfj 


©00)00© © © 





1 1 1 1 


1 


a> 


[53 x) 


CO UC © t/i © 00 1 CN t^ 1 


© 


1 1 1 1 


1 


© 


"C 


<u 


NN ^HHH 


rt 






^ 


OPQ 












ctf g 




©©05©©©©©©C0 
t^CN©CN©CNCNlO©a> 


*r> 


© ©© © 


2 


IC 


• 


© 


Oi IT) T © 


00 


00 


PQ 


COUOCNiOCOCN'-'lOCN 


Tf 


© CO 


-«* 


00 


H< 




CN 


1/:* 






cxT 




Q 


1 ~ 00 1 1 N I CO 1 1 


-«* 


1 1 "* CN 


CO 


© 




1 mt M I^M 


l-H 


1 1 TfTf< 


a 


© 




> 


uo 


co 






c^ 




fl W3 


I iC CO 1 1 CO 1 CO 1 1 


t^ 


.1 1 Tt-00 


CN 


CD 




• ~l CD 

^3 


1 TfrH | 1 | IX 1 ] 


1^ 


1 1 CN <N 


iC 


CN 














w 














T3 














m 


li 


1 COCO 1 | -. | 1 CN I 


Tf 


1 1 1 1 


! 


t 


'o 


<u cj 


1 «- II II 1 


CN 


1 1 1 1 


I 


CN 


go 












Oh 

1 














o.2 


1 © Tf | I U5 00 I © | 


t^ 


1 © © © 


© 


t^ 


« 


2* 

CO CD 

is 


1 tNt | | l-l | CN | 


IC 


I i- © CO 


t>» 


CN 




CN 


CN 


CN 


ID 














cuo • 














CN 1 ID I 1 .-h CN CN | © 


CN 


1 1 1 1 


1 


CN 




i-t 1 CN 1 1 T-, | ,-, 


CO 


1 1 1 1 


1 


CO 




3.22 














^^ 
















CN l> 00 © © Tf 1 CN CO CO 


10 


CO © CN © 


00 


CO 


C T3 


b 


0> CN CD CN © 05 | ^ -<* 00 


Tf 


OOTfrHtN 


© 


U5 


o fl • 


iCCO^lOW-i (Oh 


^" 


f* l-H 


©^ 


if} 


O ^ J2 

>3 




























co 


CO ^ © | 1^1 | CN 1 


co 


<*. j O 1 


rf 


© 


l« 


(OhO 1 1 ~ 1 1 CO I 


CN 


1 CO 1 


CO 


OJ 


1 c 


O 


*-* 


CN 






<N 


< 






















... 














. . . -M 

a 










rtc ggaflcc 












.° ° o o o o 5 o 
+3 °-P '+{ -P '+3 °-P '.j~> '+3 




$ 3 










OO • 'CJOoOuO 












CD <L> . • CO a) S <L> CD O 

cow cococococnw 














«j« ^<Wo<:cjpq 

-f-> 












3 '& 




« N 05 O 

-^ 13 — co 






- 


j 


* & 






13 




5 


13 g 
o 55 




'PH.t! 2^ 

frc.O>£ 




•I 

a 






i— "i— « CN 00 »— ii— <>— IC350501 






O 






—.— iCOCOiOiOlOCNCNCN 




45.^r^co 












•rj H-> • • 










0606666666 




3 rt O O 










fc fc £ £ £ Jz; £ fc £ £ 




S^;^^ 







MEDICAL SERVICES IN ITALY 359 

The convalescent depot for other ranks at Genoa has already 
been noted. It was on the sea front at the Lido. 

In the establishment of all these units great assistance was 
obtained from the branch of the British Red Cross Society in 
Italy, under Lord Monson. Until No. 41 M.A.C. arrived, 
ambulance cars were supplied by the society for work at 
Bordighera, Cremona, Arquata and Tortona. It also formed 
depots of stores at Genoa, Taranto, Padova and Vicenza, and 
erected a recreation hut at the men's convalescent depot, in 
addition to other valuable assistance, such as the provision of 
personnel for detention hospitals and invalid kitchens. 

The work of the sanitary services in Italy is described in the 
volumes on the Hygiene of the War. The most important 
duties falling on them were in connection with malaria, which 
was specially prevalent in Taranto, as also in the plains south 
of the front areas occupied by the British troops. 

With regard to ambulance trains, owing to the time taken 
on the return journey from front to base and back, a matter 
of at least three days, it was felt that in the event of active 
operations the four trains attached to the British Expeditionary 
Force would not be sufficient. Consequently early in June 
1918 provision was made for the preparation of four temporary 
ambulance trains. The equipment was collected at an ambu- 
lance train supply store at Voghera, and sent as required on 
empty ambulance trains to the forward area. A crew of one 
medical officer and nine other ranks was detailed for duty on 
each. They were brought into use during the final operations, 
and were formed of 1st and 2nd class Italian rolling stock 
with a kitchen coach added ; 750 to 850 sitting patients could 
be carried in each. In connexion with them rest stations 
and haltes repas were formed at Cremona and Voghera. They 
off-loaded at Genoa. 

A further provision of temporary ambulance trains was 
made for carrying sitting patients between Genoa and Mar- 
seilles. The haltes repas at Savona and Ventimiglia were 
used by them, the journey to Marseilles taking twenty-four 
hours. No. 10 Italian Red Cross train was also employed in 
evacuating patients from Genoa and Bordighera to Marseilles, 
running three days in each week. One of the Italian Maltese 
Order trains was also lent on one occasion to bring patients 
from Mestre to Bordighera. The loading stations in the 
forward area were at Mestre for the Piave front and Cavazzale 
for the Asiago front. 



360 MEDICAL HISTORY OF THE WAR 

The arrangements made for evacuating from the Italian 
base hospitals to Marseilles met all requirements, although 
at one time, in May, the A.D.M.S. of the Italian Base expressed 
anxiety regarding the small number of vacant beds reported 
from Marseilles. Sick and wounded in the Marseilles hospitals, 
however, could always be cleared when necessary to the 
northern bases in France, and there was no real cause for 
anxiety. The state of vacant beds in Italy and Marseilles 
and the number awaiting evacuation from the former is 
shown in the chart, from which it will be seen that when 
the number of vacant beds in Marseilles in May was low the 
number in Italy was high. The only period of much congestion 
in both places was after the armistice, at a time when the 
urgency of evacuation was not so great. 

The Health of the Troops. 

The battle casualties, as will have been gathered, were 
comparatively few, and, consequently, the greater part of the 
work of the medical services, apart from sanitation, was 
connected with sickness. The weekly wastage from sickness, 
however, was never excessive until October and November 
1918, when it increased to an alarming extent on account of 
the epidemic of influenza. An outbreak of this disease had 
already occurred in May and was continued in June, but 
appeared to have abated in July. At first it was thought to 
be sand-fly fever, and Lieut. -Colonel P. J. Marett, R.A.M.C, 
an expert in this disease, was ordered from France by the 
War Office to investigate it. A convalescent camp was 
established for the patients at Grumolo by a field ambulance 
of the 48th Division. Lieut-Colonel Marett reported that the 
disease was not sand-fly fever, although no very clear indication 
of its nature was elicited at the time. 

When it recurred in October it was definitely of the nature 
of influenza, and this disease was the cause of most of the 
admissions to casualty clearing stations during the time the 
British were in Italy. During the thirteen months ending 
December 1918, 10,590 cases had been admitted. The ad- 
missions for no other disease approached this figure ; inflamma- 
tion of the connective tissue and diarrhoea, which was 
specially prevalent in August, only giving 3,727 and 3,485 
admissions respectively, and pyrexia of uncertain origin 2,754. 
The admissions for venereal disease during the^eriod were 1 ,490. 
and no other disease reached the 1,000 figure. Admissions for 
frost bite and trench foot were negligible, 26 in all. 



f 

o 

"-I 
iz 

o 

i 

<£y 

| 

< Q . 

z 

ZD 

-o 
1-3. 

IS: 

* - 

rtO 

S 55 • 




c 

c 
c 
•r 


> 

> 
1 


c 

c 
c 


> 
) 
) 
i 


c 
c 
c 


) 
> 
> 




CO 

o W 


ji 

> nl 3 

•J <o < 

f J U> 

"So 




'♦ 


^>*o^^ 


< 


..TJX 







on ul 
in 












"• * 














<£-^ 


^» 


o 
«> uJ 

-I 

"• > 












s£2r_ 


*= 








-/ 


^'■^•"H 


vt 


t 








...^ 


"^ 




'"•"••.^^ __ 










H 


"?* 


^*- 

zzz 


— 




<c: 


—^^ 


« 


— „„»«* 

IT*"* .;.«' 


?*— 


•J 








^= 




"f-T 


!■ 


8- 








^> 


• 


-^ 


***■... 








;>- 


£ 


1ft 


\y 






-v^ 






^ns^r 

7* 




**£: — 






7^— 




1 






^f— 


s 

M , 

s 






















v 






+ 










V. 




^■" 












X. 




^^ 






/ 






--> 




^ 












-i> — 




^ 


•■ 




-i 


•&■■ 

-1 




v~~ 








\ — 




-fr 




/ 












*, 




\ 










V 


.• 




^ 








4 


— u^* — 


















W.„., 


•? ■? 


IO 
N 

SI 


V - " 














-^2-4. 


s ■ 

K 














o-j 

V 


— .,/ 














^ 


"••. 














"s 


,«»■ 














i 












J*\ 






k 


"v 














— 4 


"ill. 


ft 

a* 

z 

H 

la 












l" ' •*** 


Y- 4 


^1- 


8 5 










-"- 




<*c 


— :*. — 










jr 






gf f 


o»CQ 










s 






""""""^li 










< *^. 






r-^ 


- ui 
= Ik 










V 






\ ***•- 










s 


«B 




£ i***' 














>. 




")? 
















— *-£— 


t^ 


o 

o 
o 


2 o 
2 ° 

N - 





MEDICAL SERVICES IN ITALY 361 

The British troops were fairly free from the typhoid group 
of fevers in Italy, although it was prevalent in the civil 
population and the Italian army in August, September and 
October. During the year December 1917 to November 1918 
there were thirty cases of typhoid and one hundred and twenty 
paratyphoid and other fevers of the enteric group amongst 
the British. Fully one-third of these cases occurred early 
in the year, when the number of men inoculated against typhoid 
was comparatively small. A conference of Italian, French 
and British military and Italian civil medical authorities met 
in Padua in January 1918, at the instigation of the British 
D.M.S. to consider the most suitable measures for combating 
the spread of infection, and for organizing co-operation be- 
tween the Italian civil authorities and those of the Allied 
forces in improving the general sanitation of the occupied areas. 
The incidence of typhoid fever amongst the civil population 
in the autumn of 1918 was almost half that in the autumn of 
1917, apparently in consequence of the measures agreed upon 
at this conference. 

There was little else of special significance in connexion 
with the medical services of the British Force in Italy. 



CHAPTER XIX. 

THE MEDICAL SERVICES IN EGYPT. 

DURING the war Egypt was not only organized for internal 
defence but also became the base for the military operations 
on its own frontiers and in the Dardanelles, Macedonia and 
Palestine. It was also an intermediate base for troops passing 
to and from the other theatres of war in Asia, East Africa and 
Western Europe. Its eastern frontier ran from Rafa to 
Akaba, and included the Sinai Peninsula. Its western frontier 
ran from an outpost at Solium, on the Mediterranean littoral, 
southwards to the Sudan, and included the oases of Siwa, 
Baharia, Farafra, Dakhla and Kharga in the great Libyan 
desert which lies between Egypt and Tripoli. On the south 
was the Sudan, under a British administration, with its head- 
quarters at Khartum, where were also the headquarters of the 
Egyptian Army. 

The British garrison previous to the war consisted of a 
regiment of cavalry, a battery of artillery, an Indian mountain 
battery, five battalions of infantry and companies or detach- 
ments of R.E., A.S.C., R.A.M.C, A.O.C., and A.V.C., under 
the command of Major-General the Hon. J. H. C. Byng. Its 
headquarters were in Cairo. The troops occupied the Kasr-el- 
Nil barracks there, cantonments in Abbassia, just outside and 
north-east of Cairo, and cantonments in Mustapha, on the 
sea north-east of Alexandria with detachments in Alexandria. 
There were also detachments of British troops in Khartum 
and in Cyprus. The Egyptian Army, under the Sirdar, 
General Sir Reginald Wingate, was distributed to various 
posts in Egypt, the Sudan and Sinai. 

The medical services were administered by a D.D.M.S., 
Colonel N. Manders. The R.A.M.C. establishment was 20 
officers, including 2 quartermasters, and No. 33 Company (about 
116 other ranks) who were distributed to hospitals in Cairo, 
Alexandria, Khartum and Cyprus, and to reception hospitals 
or detention wards in the Kasr- el-Nil barracks and in the 
cantonments at Mustapha. The principal hospital was in 
the old palace of the Citadel, Cairo, equipped for 200 beds, 



MEDICAL SERVICES IN EGYPT 363 

but capable of expansion by stores held in reserve to 543 or 
more. The other hospitals were for 100 beds at Ras-el-Tin, 
Alexandria, for 70 at Khartum, and for 16 beds in Polymedia 
and Troodos, in Cyprus, the former of these two places being 
occupied in winter and the latter in summer. At Abbassia 
there was a small hospital under a sub-assistant surgeon of 
the I.S.M.D. for the Indian establishment of the mountain 
battery. A Soldiers' Families Hospital was in the Citadel. 
Seventeen members of the Q.A.I.M.N.S. were in the Command, 
distributed to the hospitals in Cairo, Alexandria and Khartum. 

The Egyptian Army had two modern hospitals of 200 beds 
each, one at Abbassia and the other at Khartum. They were 
under the administration of a principal medical officer, Lieut. - 
Colonel H. A. Bray, R.A.M.C. 

There was a large command depot of medical stores in the 
Citadel, Cairo. 

After war was declared the British units were practically 
all withdrawn to help in the formation in the United Kingdom 
of the 27th and 28th Divisions. They were replaced by the 
42nd (East Lancashire) Division of the Territorial Force, 
and Lieut. -General Sir J. Maxwell then replaced Major-General 
Byng as Commander-in-Chief of the forces in Egypt. 

Until it was decided, in March 1915, to send an expeditionary 
force to the Dardanelles, the chief military concern was the 
organization of the defence of the Suez Canal. The Turks 
had entered the Sinai Peninsula and were threatening an 
attack on the Canal. As a temporary measure a brigade of 
the Lahore Division on its way from India to France landed 
in Egypt on the 9th November 1914, and remained there till 
the 19th when it was relieved by an expeditionary force from 
India under Major-General A. Wilson, who arrived on the 
16th November. The Indian units were then formed into 
two new divisions, the 10th and 11th Indian Divisions, and 
the Canal defences were organized in three sections, No. 1 
with headquarters at Suez, No. 2 with headquarters at Ismailia 
Ferry, and No. 3 with headquarters at Kantara. Major-General 
Wilson's headquarters were at Ismailia, his advanced base at 
Zagazig, and base at Cairo. 

In the meantime the 1st Australian Division and the Com- 
posite Australian and New Zealand Division arrived in Egypt, 
the former early in December 1914, and the latter early in 
January 1915. They were encamped respectively at Mena, 
some five miles south-west, and at Heliopolis, some five miles 
north-east, of Cairo. 



364 MEDICAL HISTORY OF THE WAR 

When the Expeditionary Force for the Dardanelles was 
formed a base was established for it in the area between 
Alexandria and Aboukir. It became eventually, in December 
1915, the Levant Base under Major-General Altham. It 
formed part of the Mediterranean Expeditionary Force Com- 
mand, which was independent of the Egyptian Command, 
thus creating a dual control in Egypt. The two divisions 
from Australia and New Zealand were transferred to this 
base, previous to embarkation for the Dardanelles, where 
they formed the Anzac Corps. Other divisions from England, 
the 63rd (R.N.) and the 29th, also occupied camps there for 
a short time in March and April, and the 52nd (Lowland) 
Division in June 1915, previous to embarking for the Dar- 
danelles. In November 1915 the 28th Division from France 
was also temporarily encamped there previous to going to 
Salonika. The Levant Base also became a large Base 
Depot for reinforcements and supplies to the Mediterranean 
Expeditionary Force. It ceased to exist in March 1916. 

The military operations in Egypt, until the beginning 
of 1916, were confined to patrol work and repelling raids 
by the enemy on the Canal, and to extensive operations on 
the western frontier of Egypt. Most of the raids on the 
Canal were of a minor character, but on the 3rd February 
a determined attempt was made to cross the Canal at Toussum 
south of Ismailia, between the Great Bitter Lake and Lake 
Timsah, and at other points. Enemy camps within striking 
distance of the Canal were attacked by mobile columns from 
Egypt, especially on the 23rd March and 28th and 29th April. 

Various Yeomanry units from the United Kingdom, mounted 
troops from Australia and New Zealand, the Bikanir Camel 
Corps, and an Imperial Service Cavalry Brigade from India 
came to Egypt during this early period. 

On the western frontier the followers of the Senussi com- 
menced to threaten the Nile delta from the western desert 
and extensive military operations had to be undertaken to 
safeguard the Nile valley and delta from attacks from the 
west between November 1915 and April 1916. On the 5th 
and 7th November 1915, the crews of a British naval ship 
and transport which had been torpedoed landed on the coast 
of Cyrenaica, and were held prisoners by the followers of the 
Senussi, who then attacked the frontier post at Solium. The 
post was withdrawn to Mersa Matruh, halfway between 
Alexandria and Solium, and a force, the Western Frontier 
Force, concentrated there under Major-General M. G. Wallace. 




MAP OF EGYPT 

SHOWING AREAS OF OPERATIONS 
SCALE 
100 

Ra/'/ways shown 



MalbyiSonti.Litli 



MEDICAL SERVICES IN EGYPT 365 

At the same time a Southern Force, under Major-General Sir 
John Adye, was engaged in defensive operations against 
threatened attacks from the Baharia oasis. The Dakhla and 
Kharga oases were at that time occupied by the enemy and 
Sir John Adye's force was employed on patrol duty from 
Fayum to Assiut and Esna on the Nile. 

The campaign against the followers of the Senussi came to 
an end in March 1916, and the Southern and Western Frontier 
Forces were then combined in one command as the Western 
Force. Minor operations continued to be conducted by it for 
re-establishing Egyptian rule in the oases and protecting the 
western frontier. The Kharga oasis was re-occupied on 15th 
April and a garrison of 1,660 established there. The Moghara 
oasis was fortified on 27th April, raids were made from Solium 
to destroy enemy ammunition dumps on the 7th, 11th, 23rd 
and 30th April. The construction of railways towards Baharia 
and Kharga was undertaken, and block-houses and patrols 
on camels and in motor-cars were maintained to prevent access 
to the Nile valley and delta. A thousand miles of front had 
thus to be watched on the west. The Baharia and Dakhla 
oases were occupied in October 1916 and Farafra in November, 
permanent garrisons being placed in them. Siwa oasis was 
entered from Matruh by armoured cars on 5th February 1917 
with slight opposition. 

While these events were taking place, operations were 
conducted from the Sudan against the Sultan of Darfur. A 
mobile column of some 3,000 in strength, under Lieut.-Colonel 
P. V. Kelly, was assembled in March 1916, and during the 
following two months traversed a waterless desert for 300 
miles west of the railhead at El Obeid. Mechanical and camel 
transport was employed on sections of the advance. On May 
22nd, a battle was fought at Beringia near El Fasher with 
the loss of 5 other ranks killed or died of wounds, and 3 officers 
and 18 other ranks wounded. El Fasher was occupied on the 
following day. The operations then ceased, but, although not 
marked by any outstanding incident, this short campaign 
was remarkable for the manner in which the difficulties of 
moving columns for so many miles in the desert were 
overcome. 

When the expeditionary force was withdrawn from the 
Dardanelles to Egypt at the end of 1915 and beginning of 
1916 and reorganized there as the Egyptian Expeditionary 
Force, a command, independent of the command of the forces 
in Egypt, was established for the defence of the Suez Canal 



366 MEDICAL HISTORY OF THE WAR 

and the protection of Egypt from attacks by the Turks. Sir A. 
Murray, who took over this command from Sir C. Monro on 
the 9th January 1916, had under him all the organized forma- 
tions east of a line drawn about five miles west of and parallel 
to the Suez Canal, generally speaking the area of the Sharquia 
Province of Egypt. The first step was the reorganization 
and equipment of a mass of unabsorbed Australian and other 
reinforcements at the Levant Base, the organization of 
mechanical and other transport, and the formation of training 
centres with a view to an offensive defence. The G.H.Q.. 
of the command was at Ismailia. A mobile force with riding 
and transport camels was formed for an advance from Kantara 
towards Katia and El Arish. The scheme of operations was 
to concentrate at Katia for an advance to positions east of 
it- and construct a broad gauge railway and road for the advance ; 
as also a pipe-line for supply of water from the Sweet Water 
Canal at Ismailia. 

On the 19th March 1916, Sir J. Maxwell left Egypt. Sir A. 
Murray formally took over the whole command in Egypt and 
the dual control then ceased to exist. The staff was reorgan- 
ized, the Levant Base abolished, a Delta District Command 
with headquarters at Cairo for L. of C. defences established, 
and the Western Force* for defence of the Nile formed in two 
sections, a Northern and Southern, the boundary between them 
being a line drawn from east to west through Deirut. G.H.Q. 
remained at Ismailia. 

The Anzac Corps was transferred to France and a second 
Anzac Corps organized, under Lieut-General Sir A. Godley, 
of the 4th and 5th Australian Divisions. 

During April 1916 reconnaissances were carried out by 
troops from the Suez Section (No. 1) and the Ismailia Section 
(No. 2) of the Canal Defences by detachments of the Australian 
Light Horse and Bikanir Camel Corps. 

No. 3 Section (Kantara) became the base for the defensive 
advance into the Sinai Peninsula, the first objective being 
the Katia District, a water-bearing zone of about 15 miles 
extent. Katia was some 30 miles from Kantara. The railway 
line reached to within 7 miles of it by the 21st April 1916, 
and was then near enough for a general advance to be made. 
A Katia District Command under No. 3 Section of the Canal 
Defences had been formed about a fortnight earlier with an 

* The command of this Force was taken over from Major-General Peyton 
by Major-General C. Dobell and in May 1916 by Sir Bryan Mahon, but 
shortly afterwards by Major-General A. G. Dallas. 



MEDICAL SERVICES IN EGYPT 367 

advanced post at Oghratina, 5 miles east of Katia, held by 
a squadron of yeomanry. A mobile column, designated the 
Desert Column, was formed under Lieut-General Hon. Sir A. 
Lawrence, as the advanced guard of No. 3 Section of the 
Canal Defences, and subsequently of what was designated 
the Eastern Force under Lieut.-General Sir C. Dobell. 
The Eastern Force Command included all sections of the 
Canal Defences. It received the designation " Eastern 
Force " in October 1916. 

On the 23rd April 1916, the positions were attacked by a 
large enemy force. The post at Oghratina was overwhelmed 
and destroyed. Katia was attacked and fell, and the British 
force retired to Dueidar, some 13 miles east of Kantara. The 
enemy attacked Dueidar but was repulsed. The British 
casualties in this affair were 2 officers and 18 other ranks killed, 
and 4 officers and 21 other ranks wounded, in addition to 
three and a half Yeomanry Squadrons and other details lost 
at Oghratina and Katia. 

Beyond bombing and reconnaissance of enemy camps 20 
to 30 miles east of Katia, and destruction of a water supply in 
rock cisterns 40 miles south-east of Ismailia, there were no 
active hostilities until the 4th August 1916. On that date 
the first important battle on the Eastern front was fought, 
and from then onwards the Desert Column and Eastern Force 
steadily advanced along the coast route of the Sinai Peninsula, 
and cleared it of the enemy by the occupation of Rafa on 
the 9th January 1917. Unsuccessful efforts were made for 
the capture of Gaza on 26th March and 17th to 19th April 
of that year. The attack on Gaza was to be resumed on the 
20th April but, as the losses likely to be involved could not 
be justified, further operations were abandoned and a period 
of trench warfare ensued which lasted until the end of October 
1917, the Eastern Force entrenching itself from Tel-el-Jemmi 
on the Wadi Ghuzzee to El Ajlin on the coast west of Gaza,, 
with cavalry patrols working to the south and south-east. 

The Eastern Force then came under the command of Lieut.- 
General Sir P. Chetwode, and the Desert Column under Major- 
General Sir H. G. Chauvel. 

The Canal Zone was organized into a Southern and Northern 
Section, the latter being reorganized as the Palestine L. of C. 
from the Suez Canal to Khan Yunus in May 1917. 

General Sir E. Allenby succeeded Sir A. Murray in command 
of the Egyptian Expeditionary Force on 28th June 1917,. 
and from that time onwards to the end of the war the military 



36S MEDICAL HISTORY OF THE WAR 

situation, so far as Egypt was concerned, was that of a base 
for the operations in Palestine. No active operations of any 
moment were carried on in Egyptian territory. 

For the advance into Palestine the organization of the 
Eastern Force and Desert Column was changed into that of 
an Army of two Corps, the XXth and XXIst, of three divisions 
each, and a Desert Mounted Corps of three mounted divisions. 
Palestine was definitely invaded in September 1917 by this 
force. Gaza and Beersheba fell ; the army rapidly advanced 
and held a line from Jaffa to the Jordan valley from the end 
of 1917 to September 1918, when a decisive battle was fought, 
leading to the occupation of Damascus and the territory 
north of it. During these operations alterations were made 
in the composition of the Mounted Corps and the XXth and 
XXIst Corps. The 3rd and 7th Indian Divisions, which had 
fought in France and subsequently in Mesopotamia, replaced 
British divisions in January and May 1918. A fourth mounted 
division was added to the Mounted Corps. Hostilities against 
the Turks eventually ceased with an armistice on the 30th 
October 1918. 



Administration of the Medical Services. 

The preceding sketch of the military situation in Egypt 
during the war and the operations for its defence will serve 
to indicate how complicated and difficult the administration 
of the medical services became. When the British garrison 
was withdrawn and replaced by the 42nd Territorial Division, 
Australian, New Zealand and Indian troops in 1914, the 
D.D.M.S., Colonel N. Manders, his D.A.D.M.S. for Sanitation, 
Major Bagshawe, and the senior medical officers at Cairo 
and Alexandria, Lieut. -Colonels Knaggs and Beach, of the 
original R.A.M.C. garrison remained. 

The 42nd Division had its A.D.M.S., Colonel J. B. Mann,* with 
it, and the Indian troops a D.D.M.S., Colonel Robinson, I.M.S., 
while the Director-General of the Australian Army Medical 
Corps, Surg. -General Williams, accompanied the Australian 
contingent to Egypt. Consequent upon this multiplication 
of administrative medical interests, a D.M.S., Surg.-Generai 
R. Ford, was appointed to the staff of Sir John Maxwell. He 
arrived in Egypt towards the middle of December 1914. He 
organized an administrative medical staff for Alexandria, 

* Colonel Mann was invalided in June 1915 and was succeeded by- 
Colonel T. P. Jones, R.A.M.C. 



MEDICAL SERVICES IN EGYPT 369 

Cairo, and the Canal Defences, Colonel Manders becoming 
A.D.M.S., Cairo, Colonel Beach, A.D.M.S., Alexandria, and 
Colonel Robinson D.D.M.S., of the Indian troops and Canal 
Defences, with the A.Ds.M.S. of the new Indian divisions 
manning the Canal sections under him. The A.Ds.M.S. of the 
Australian Division, Colonel Howse, and of the New Zealand 
and Australian Division, Colonel Wills, were under the direct 
administration of the Director-General Australian Medical 
Corps ; but Surg.-General Williams left shortly after his 
arrival for London and did not return till February 1915, 
and went back to Australia in the following April. He again 
passed through Egypt in June 1915, and took his office staff 
with him then to London. The D.M.S., Egypt, consequently 
appointed an Australian medical officer, Lieut. -Colonel Barrett, 
as an A.D.M.S. on his staff, to represent the Australian Medical 
Service. 

When it was decided to send an Expeditionary Force to the 
Dardanelles, a form of dual medical control was evolved in 
Egypt. An A.D.M.S., Colonel Sexton, was appointed to 
administer the medical services of the docks and camps of 
the Dardanelles Expeditionary Force base at Alexandria 
and between that city and Aboukir. He was under the 
control of the D.M.S. of the Expeditionary Force, who was 
independent of the D.M.S. , Egypt, although his duties were 
apt to conflict with and overlap those of the A.D.M.S., 
Alexandria. 

Owing to the demand for co-ordination of medical adminis- 
tration, not only in Egypt and the Dardanelles, but also in 
Malta and Gibraltar, and subsequently in Macedonia, the 
Army Council appointed a Principal Director of Medical 
Services for the Mediterranean generally with headquarters 
in Egypt. Surg.-General W. Babtie, then D.M.S., India, 
was appointed and arrived in Egypt on 15th June 1915,* 
with Lieut.-Colonel T. A. Granger, who held a similar appoint- 
ment on his staff in India, as his A.D.M.S. He then 
brought Lieut.-Colonel Stammers from Malta to act as his 
A.D.M.S. for Sanitation. 

Surg.-General Babtie and his staff were not attached to the 
staff of any military commander, and had no permanent 
office until a month later, when one was established in Alexan- 
dria, and towards the end of 1915, in Cairo. The position 
of an administrative medical officer attached to no military 

* He had already paid a visit of inspection of the Indian Expeditionary- 
Force in Egypt, in February and March 1915. 

(10134) GG 



370 MEDICAL HISTORY OF THE WAR 

command was anomalous, and led to a form of triple adminis- 
tration in Egypt, that of the P.D.M.S., of the D.M.S., and 
of the A.D.M.S., Mediterranean Expeditionary Force base as 
representing the D.M.S. of that Force. Surg.-General Babtie's 
functions may, however, best be described as those of inspec- 
tion and co-ordination of the medical work of the various 
Mediterranean Commands and Expeditionary Forces on behalf 
of the Director-General of the Army Medical Service at the 
War Office. When he was appointed by the Army Council, 
the duties assigned to him were to assume command of the 
medical services of the Mediterranean Expeditionary Force, 
Egypt and Malta, and be responsible for their co-ordination 
in these three commands. He was made directly responsible 
to the Army Council for the general working of the medical 
services and to the Commanders-in-Chief for any advice or 
action taken in their commands. But his duties did not 
relieve the Ds.M.S. of the Commands of their responsibilities 
and administration. He was also to arrange for the reception 
of the sick and wounded from the Dardanelles in Egypt and 
Malta, and for an equitable distribution of personnel in the 
three commands ; to tender advice with regard to sanitation 
and to co-operate with the Q.M.G/s branch of the staff and 
the Naval Transport Officer for the working of hospital ships.* 

For a considerable time the evacuation of sick and wounded 
to and from Egypt was in the hands of Surg.-General Sir J. 
Porter, formerly Director-General of the Royal Navy Medical 
Services, who had been appointed Principal Hospital Transport 
Officer in July 1915. His headquarters were at Mudros, but 
he was represented at Alexandria by Engineer-Captain Ter 
Veen, R.N. With both of these officers Surg.-General Babtie 
was in constant touch. This method of directing evacuation, 
however, did not prove satisfactory and came to an end at 
the beginning of December 1915, when the control of evacuation 
of sick and wounded to and from Egypt was taken over by 
the P.D.M.S. Surg.-General Babtie was recalled for duty at 
the War Office in March 1916, and the appointment of a 
P.D.M.S. Mediterranean was then abolished. 

On the return of the Dardanelles Expeditionary Force to 
Egypt at the end of 1915 and beginning of 1916, the D.M.S. 
of the Force administered, independently of the D.M.S., 
Egypt, the area under the command of Sir A. Murray ; but 
when the dual command ceased in March 1916 with the forma- 
tion of the Egyptian Expeditionary Force, the D.M.S. of that 

* See Final Report of the Dardanelles Commission, p. 155. 



MEDICAL SERVICES IN EGYPT 371 

Force administered the whole of the medical services in Egypt 
and its frontiers. Dual medical control thus ceased also, 
but a number of subordinate administrative medical appoint- 
ments were made then or had been made previously. There 
were thus an A.D.M.S. for the Western Frontier Force, an 
A.D.M.S. for the Southern Force, and a D.D.M.S. or A.D.M.S, 
for each of the three sections of the Canal Defences. An 
A.D.M.S. was also appointed for Egyptian hospitals, which 
were provided for the sick and wounded of the Egyptian 
Labour and Camel Transport Corps and Turkish Prisoners 
of War. On the departure of the Indian divisions from the 
Canal Defences, Colonel Robinson's appointment as D.D.M.S. 
of the Defences lapsed, but he remained in Egypt as D.D.M.S. 
for Indian troops and hospitals. On the abolition of the 
Levant Base, its A.D.M.S. became a D.D.M.S. for the L. of C. 
of the Egyptian Expeditionary Force. 

On the formation of the Eastern Force and Desert Column 
for the advance in the Sinai Peninsula, a D.D.M.S. was 
appointed to each, the D.D.M.S. of the Desert Column being 
regarded as subordinate to the D.D.M.S. of the Eastern Force. 
The Canal Sections were then administered by D.A.Ds.M.S. 
under the D.D.M.S., Eastern Force, and the divisions of the 
Force and Desert Column by divisional A.Ds.M.S. The 
D.D.M.S., L. of C, was abolished. He became D.D.M.S. of 
the Eastern Force, while the D.D.M.S. of the 3rd Section of 
the Canal became D.D.M.S. of the Desert Column. 

When these changes in organization took place, the Western 
Frontier Force and Southern Force were merged into one. 
The A.D.M.S. of the latter became the A.D.M.S., Western 
Force. This appointment was again merged into that of an 
A.D.M.S., Delta and Western Force, in February 1917, and 
eventually at the end of the year divided into two administrative 
appointments, that of A.D.M.S., Delta, for lower Egypt, and 
A.D.M.S., Egypt, for upper Egypt. The only appointment 
which remained unaltered throughout was that of A.D.M.S., 
Alexandria. 

Finally, when the forces were reorganized by Sir E. Allenby 
into corps for the invasion of Palestine, a D.D.M.S. was 
appointed to each corps, under the D.M.S. of the Expeditionary 
Force ; while the medical services on the Palestine L. of C. 
were placed under the administration of an A.D.M.S. 

The staffs of the administrative medical officers consisted 
of Assistant or Deputy Assistant Directors of Medical Services 
for general and sanitary duties. But in addition to these there 



372 MEDICAL HISTORY OF THE WAR 

were several consultants, specialists and scientific workers 
attached to the administrative medical services. During the 
Dardanelles period there were at least six consulting surgeons, 
who took it in turn to serve in Egypt, Mudros or Gallipoli. 
A War Office Advisory Committee on Epidemic Diseases, 
known as the " Hunter Committee," under the chairmanship 
of Colonel W. Hunter, had its headquarters in Egypt and 
visited the various areas of operations in Egypt, the Dardanelles 
and Macedonia. A local committee, under Sir David Semple, 
the Director of Public Health in Egypt, was appointed by the 
D.M.S., Egypt, to supervise the sanitation of the Canal Zone. 
Lieut. -Colonel Sir R. Ross was sent by the War Office to 
Egypt and Macedonia in the summer and autumn of 1915 in 
connexion with anti-malarial measures. Lieut. -Colonel Leiper 
was appointed to investigate the causes of bilharziasis, and 
Major Austen to advise on fly and mosquito prevention. 
Their work is described in the volumes on the Hygiene of the 
War. 

The Medical Units. 

The Field Ambulances. — The only medical units which 
arrived with the Indian and Dominion Contingents and the 
42nd Division (T.F.) in 1914, were the field ambulances. With 
the arrival of Yeomanry, and other mounted units, and with 
formations composed of Indian and British troops, the variety 
of field ambulances became great and the designations of 
many of them were frequently changed. There were R.A.M.C. 
field ambulances with British divisions, mounted field ambu- 
lances with Yeomanry brigades, Indian field and cavalry field 
ambulances and combined field and cavalry field ambu- 
lances for those divisions which included Indian units. 
Australian and New Zealand divisions and mounted brigades 
had their own field ambulances. All these changed their 
designations with each change of designation in the formation to 
which they belonged or were attached. British became 
Indian, Indian British, mounted dismounted, Yeomanry camel 
corps field ambulances, and practically every variety of change 
took place, as may be indicated by a glance at the accompanying 
chart, which shows how some field ambulances went through 
various phases of change, with, eventually, the entire loss 
of their original identity. 

The equipment of field ambulances depended on the character 
of the operations. Desert transport replaced the ambulance 
wagons and cars in operations in the desert, but ambulance 



Chart showing the changes which took place in 
the designation of certain field ambulances 
during the egyptian and palest ine operations 

/9I8 



UNIT 



J9I6 



1917 



t/2 S:W<st Border MCd.Bdt.f. A. 



£ 



* 



Wtlth Border Mtd. Bde. F. k . 
DistnCd. (Yco.) Bdc.F. A 



N*2o/ F.A. 



1/1 Miohlond Mtd.Bde.F.A 



It 



1/1 Lowland Mtd.Bde. flT. 



N« 229 F A. 



l/f Eastern Mtd.Bde. F.K. 



m 



1/1 SrEasttrn Mtd. ftd«. F.A 



N« 22>0 F. A 



1/lScottUh Horse F.A! 



Imperial Camel Corps FA. 



J/2 S. Midland Mtd.Bdt.F.A 



»« Mtd. Bdc F.A 



W 



Mhow Cavalry Bdc. FA 



6* Mtd. Bde. Comb. F. AT 



10* Cavalry Bdc. Comb. F.A 



»/4 London Mtd. Bdt."F7AT 



B* Mtd. Bde. F.A. 



a 



Luck now Cav. Bde. F.A. 



8«HLuckno*a MMTBdt. F.A. 



S 



N*7j5j Indian Comb. F. A. 
1 I * Cav. Bde. Comb. F. AT 



*=7 



>/l N. Midland Mtd. Bde. F.A 



22"* Mtd. Bde. F.A. 
Siatkoht Cav. Bde. F.A" 



Ik 



NO- 109 Indian Comb. F. A~ 
22 nd Mtd. Bde. Comb. FA 






12** Cav. Bde. Comb. FTST 



1/1 S. Midland Mtd.Bdt.F.A 



5* Mtd. Bde. FA. 



Awbala Cav. Bde. F.A. 
5*> Mtd. Bde- Comb. FA? 



7=7 



13 * Cav. Bde. Comb. FA- 



1/1 Notfr & Derby Mtd.BdtlFA 



7* Mtd. Bde. F.A. 



Sccunderabad Cav. Bdc. F.A 
7* Mtd. Bdc. Comb. F.A 



Bdc. 



I4th Cav. Bc(T. Comb. F.A. 



N°I24 Indian Cav. FA" 



3F 



^ 



Jodhpur Cav. Bde. F.A 



IS* Cav. Bde. Comb. F.A. 



N°J21 Indian F.A. 
N° 121 Indian Comb. FA: 



N° IIP Indian FA. 
N»I57 Indian F.A 



N°I23 Indian F.A 



N° 123 Indian Comb. F.A. 



—Hi 



THE BLACK COLUMNS INDICATE THE PERIODS DURING WHICH THE DESIG- 
NATIONS REMAINED UNALTERED; THE ARROWS SHOW THE AMALGAMATIONS 
OR CHANGES IN DESIGNATION WHICH SUBSEQUENTLY OCCURRED. 



13 28480.5060/ 14-1. 1500. //.23. 



H.M.S.O..C' 



MEDICAL SERVICES IN EGYPT 373 

cars were again given to them when roads were suitable. 
As a rule, especially in the operations of the Desert Column, 
the field ambulances were formed into mobile and immobile 
sections, the latter depending for their movements on any 
camel transport that might be required being provided at 
the time. The mobile sections were provided with camel cacolets, 
sand carts, sand sledges, and bicycle or wheeled stretcher carriers. 
These took the place of the normal ambulance car and wagon 
transport ; but a modified scale of motor ambulance cars was 
allotted to divisions. In this way two of the three sections 
of a field ambulance were made mobile, and one immobile. 

Ambulance Convoys. — Only one organized motor ambulance 
convoy, No. 35, was sent to Egypt in March 1917 ; but motor 
ambulance convoys had been improvised for work at Alexandria, 
Cairo and Kantara, chiefly of cars provided by the Australian 
and New Zealand Governments, but also by ambulance cars 
of divisions sent to the Dardanelles, and by cars withdrawn 
from the divisions in Macedonia. Thus, there were at one 
time 45 cars at Alexandria, 30 at Cairo and 30 at Kantara. 

For work with the columns motor ambulance convoys 
were improvised of the cars of field ambulances. Camel 
convoys were also formed with cacolets and litters as reserve 
convoys for clearing dressing stations over desert routes. 

Ambulance Flotillas.- — On the Canal ferry boats, motor 
launches, barges and steamers were used for the transport 
of sick and wounded. Two Nile steamers, the " Niagara," and 
" Indiana," were specially fitted as hospitals to carry 50 
lying or about 200 sitting. They were employed for bringing 
patients from posts on the Canal to the hospitals at Port Said, 
Ismailia or Suez. 

Casualty Clearing Stations. — In the early stages of the war 
Egypt possessed no casualty clearing stations ; but No. 1 
Australian CCS. stayed in Egypt during the first three months 
of 1915, previous to going to the Dardanelles, and those with 
the Dardanelles Force returned with it to Egypt and remained 
there for a longer or shorter period until distributed to other 
theatres of war in 1916. Nos. 24, 26, 35, 53 and 54 C.C.Ss. 
were thus in Egypt in 1916 and were retained throughout 
the year. No. 24 went to France in March 1917 and No. 35 
to Salonika in May 1918. No. 53 was re-designated No. 65, 
and No. 54 became No. 66 CCS. in July 1917. At the same 
time four new casualty clearing stations were organized, 
Nos. 74, 75, 76 and 77, in Egypt. Nos. 65, 75 and 77 were 
disbanded in June 1918, on the formation of new casualty 



374 MEDICAL HISTORY OF THE WAR 

clearing stations, designated combined clearing hospitals ; 
so that at the time of the armistice only Nos. 26, 66, 74 and 
76 retained their original designation. 

All these casualty clearing stations were employed on the 
Palestine Lines of Communication, under the administrative 
control of the A.D.M.S. of the L. of C. ; but during the opera- 
tions in the Sinai Peninsula they were directly under the 
D.D.M.S. of the Eastern Force or Desert Column. They 
were units at that time, which retained more or less the 
equipment of a casualty clearing station on mobilization 
scale, and did not expand into the large immobile units which 
were evolved during trench warfare on the Western front, 
and later in Palestine. 

In 1918, when Indian Divisions replaced British Divisions 
in the XXth and XXIst Corps in Palestine, six combined 
casualty clearing hospitals for British and Indian sick and 
wounded were organized, and numbered 15, 24, 31, 32, 33 and 
34. The first three of these came direct from India, and the last 
three were formed by the disbanding of Nos. 65, 75 and 77 C.C.Ss. 

Ambulance Trains. — Ambulance trains were constructed 
in Egypt when the Indian Expeditionary Force arrived in 
December 1914. Three ambulance train units, designated 
X, Y and Z, were mobilized in Poona and sent to Egypt. 
They took over three hospital trains, which had been prepared 
in the railway workshops at Cairo in anticipation of their 
arrival. These trains were composed of nine coaches, of 
which seven were fitted for carrying twenty patients each 
in double-tier cots, with the exception of one, which was 
partly occupied by one of the medical officers, and as a dis- 
pensary and bathroom. There were also coaches for the 
commanding officer, personnel, kits, rations and other articles, 
and a dining car of the ordinary type. 

A fourth and a fifth train were formed later on in 1915, 
the former staffed by personnel from one of the Indian hospitals. 
All these trains were employed in Egypt west of the Suez 
Canal. The Indian ambulance train units were eventually 
withdrawn in April 1916, and replaced by R.A.M.C. personnel. 
When a railway was constructed into the Sinai Peninsula, 
new ambulance trains were prepared or improvised. They 
had to be lighter than those employed on the lines west of 
the Canal. The first two of these, No. 6 and No. 7, were 
formed at the end of 1916, the former of six coaches of the 
London and South Western Railway, with fixed cots, and 
the latter apparently of converted third-class carriages with 



MEDICAL SERVICES IN EGYPT 375 

the stretchers carried on slings. An emergency train was 
prepared with stretchers on Brechot-Desprez-Ameline frames. 
They were used during the first battle of Gaza, and a ninth 
train was added after the battle. Up till then Egyptian 
Labour Corps and Camel Transport Corps sick and wounded 
and Turkish wounded prisoners of war were carried in coaches 
attached to these trains, but this proved inconvenient, and 
the coaches for them were formed into No. 10 and No. 11 
Trains for Egyptian and Turkish sick and wounded. 

After the invasion of Palestine, an ambulance train, No. 40, 
constructed in England for the Mediterranean Line of Com- 
munication, was sent to Egypt, and the trains No. 1 to No. 11 
were re-numbered to avoid confusion with the numbered 
ambulance trains in France and elsewhere. Nos. 1, 2 and 3 
became Nos. 44, 45 and 46 Ambulance Trains. Others were 
re-numbered 43, 47, 48, 49, 50, 51, 56, and 57 ; but changes 
in numbering occurred more than once, and are not clearly 
recorded. No. 49 and No. 57 were the new numbers given 
to trains Nos. 10 and 11 for Egyptians and prisoners of war. 
The general result, however, is that five trains were employed 
west of the Canal, and six or seven east of the Canal, while 
only one, No. 40, was of the type used in France and Italy. 

As only Nos. 6 and 7 Trains were available east of the Canal 
during the operations in the Sinai Peninsula, a number of 
improvised truck trains were used as occasion required They 
went up with supplies to railhead and were fitted there by a 
sanitary section to carry slighter cases of sick and wounded 
on the return journey. The trucks had tarpaulin covers, 
and were provided with mattresses and pillows for the patients. 
Arrangements were made for hot meals being given at stations 
along the route. An orderly was placed in each truck, and 
this personnel, with the mattresses and pillows, returned to 
railhead in the next outward journey of an ambulance train. 

None of these trains east of the Canal were permitted to 
cross the Canal into Egypt. They ran as far as Kantara on 
the east bank, and the sick and wounded were received into 
the medical units there, taken across the Canal in ambulance 
cars, and entrained on the west bank in the Egyptian trains 
for distribution to the hospitals in Egypt. 

Hospitals. — The military hospitals in Egypt before the 
war have already been described. They were expanded to 
their utmost capacity. The 42nd Division brought no medical 
units with it other than its three field ambulances. Similarly, 
the two Australasian divisions arrived with field ambulances 



376 MEDICAL HISTORY OF THE WAR 

only ; so that hospital accommodation had to be provided 
in the existing hospitals until general and stationary hospitals 
and casualty clearing stations in proportion to the number of 
troops and formations in Egypt arrived. 

The units forming the 10th and 11th Indian Divisions were 
accompanied by field ambulances and by two Indian General 
Hospitals, No. 5* and No. 8, which arrived in Egypt early in 
December 1914. A third Indian General Hospital, organized 
by a voluntary committee and known as the Bombay 
Presidency General Hospital, arrived a month later. These 
hospitals were at first placed at Kantara and Suez, but were 
moved later to permanent buildings in the Citadel, Cairo, and in 
Alexandria, with a detachment at Suez. No, 5 Indian General 
Hospital remained in Egypt till the end of the war, being 
eventually concentrated at Suez, with a section at Kantara 
during the operations in Palestine. No. 8 and the Bombay 
Presidency Hospital returned to India in April 1916, after 
the 10th and 11th Indian Divisions were broken up. 

Immediately after the Australian divisions arrived in Egypt 
the want of Lines of Communication hospitals for their sick 
and wounded was realized. A casualty clearing station 
(No. 1 Australian), two stationary hospitals (No. 1 and No. 2 
Australian) and two general hospitals (No. 1 and No. 2 
Australian) were organized and equipped in Australia on the 
scale of the corresponding units in War Establishments. They 
arrived in Egypt early in January 1915. Until then the sick 
of the 1st Australian Division were received into a temporary 
hospital in the Mena Palace Hotel, staffed by its field ambulances, 
and those of the 2nd Australian and New Zealand Division 
into the military hospital, Cairo. The casualty clearing 
station (No. 1 Australian) was placed at Port Said, where 
it formed a small hospital in anticipation of fighting on the 
Canal. It joined the Mediterranean Expeditionary Force in 
March 1915, returned to Egypt in January 1916, and went 
to France at the end of March 1916. 

On arrival in Egypt No. 1 Australian Stationary Hospital 
was placed in the camp of the Australian Light Horse at 
Maadi, and No. 2 in the camp at Mena. The former 
moved to the base camps of the Mediterranean Expeditionary 
Force at Alexandria and went to Mudros in advance of 
the main body of the Dardanelles force. No. 2 accompanied 
the Force to the Dardanelles in April 1915, but returned in 

* No. 5 had included in its organization sections of No. 6 Indian General 
Hospital. 



MEDICAL SERVICES IN EGYPT 



377 



January 1916 and remained with the Egyptian Expeditionary 
Force till the end of the war. No. 1 Australian Stationary 
Hospital also returned to Egypt from the Dardanelles and left 
in August 1916 for England. 

A stationary hospital had also been organized in New 
Zealand. It went, however, to Salonika, returned to Egypt 
in March 1916, and left for France three months later. The 
only other New Zealand hospital unit in Egypt was a general 
hospital which became No. 2 Stationary Hospital and was 
opened in the Egyptian Army Hospital at Abbassia after 
the Dardanelles Expeditionary Force was organized. 

No. 1 Australian General Hospital opened in the Heliopolis 
Palace Hotel and No. 2 in the Mena Palace Hotel on arrival, 
but the latter was transferred to the Gezira Palace Hotel 




No. 17 General Hospital, Alexandria. 

west of Cairo on the Mena camp breaking up. Both these 
units remained in these localities until they were moved to 
France with the Anzac Corps in March 1916. 

These were the only medical units in Egypt until the 
Mediterranean Expeditionary Force was formed, other than 
the field ambulances and the Army Base Depot of Medical 
Stores in Cairo. The amount of sickness, however, was great, 
and the hospitals, especially No. 1 Australian General Hospital, 
gradually expanded, taking over one building after another 
in Heliopolis, until it became a unit of considerable dimensions, 
with sections for infectious and venereal diseases. Eventually 
some of the sections developed into separate units and were 
taken over by the R.A.M.C. 

When it was decided to undertake operations in the 
Dardanelles, four general hospitals were sent to Egypt from 
the United Kingdom, to act as base hospitals for the force. 



(10134) 



GG* 



378 



MEDICAL HISTORY OF THE WAR 



Two (Nos. 15 and 17) arrived in March, and the other two 
(Nos. 19 and 21) at the beginning of June 1915. They were 
all opened in Alexandria, No. 15 in the " Abbassia Schools," 
No. 17 in the Victoria College, No. 19 in the Deaconesses' 
Hospital, a German hospital, and No. 21 in Ras-el-Tin 
barracks. They were nominally under the administrative 
control of the D.M.S. of the Mediterranean Expeditionary 
Force, Surg. -General W. G. Birrell, whose representative 
in Egypt was Colonel Sexton, the A. D.M.S. of the Base at 
Alexandria. The inconvenience of the administrative control 
not being in the hands of the D.M.S., Egypt, was, however, 




Tented portion of No. 17 General Hospital, Alexandria. 



obvious from the very first, and it was subsequently arranged 
to place them under the administrative control of the A. D.M.S., 
Alexandria District. With the exception of No. 15, which 
was closed in April 1918* all of these general hospitals 
remained till the end ot the war in Egypt. 

The French " Armee Expeditionnaire d'Orient," under 
the command of General D'Amade, was encamped at 
Alexandria previous to embarking for the Dardanelles ; and 
the sick from it were admitted to the French hospital in 
Alexandria and also to the Bombay Presidency General 
Hospital, which was close at hand. The latter was, in fact, 

* The personnel of this hospital was transferred to Salonika to form 
No. 64 General Hospital there. 



MEDICAL SERVICES IN EGYPT 



379 



handed over to the French and the Indian sick transferred 
to the Indian General Hospitals. 

During April 1915 great activity prevailed in Egypt in 
anticipation of a large number of sick and wounded being 
received from the Dardanelles. No. 1 Australian General 
Hospital was expanded, as already noted, by taking over 
the Luna Park Buildings and other buildings at Heliopolis, 
and the Hyat Hotel at Helouan, both of which could expand to 
between 1,500 and 2,000 beds each, while No. 2 Australian 
General Hospital, in moving from Mena Palace to the Gezira 
Palace Hotel, increased, its accommodation to about 1,000 
beds, retaining the Mena Palace Hotel as an overflow hospital. 




Dining hali and ward at Xo. 17 General Hospital, Alexandria. 



The Military Hospital in Cairo Citadel was expanded and 
improved. A fine modern hospital, the Austrian Hospital, 
at Choobra, near Cairo, was taken over for infectious cases. 
The Egyptian Government hospitals at Alexandria, Suez and 
Port Said were prepared to receive wounded, and the large 
native hospital, Kasr-el-Aini in Cairo, was also warned to be 
ready. The Greek hospital at Alexandria placed 170 beds at 
the disposal of the military authorities, and a convalescent 
camp was established at Mustapha The British Red Cross 
Society also began to take action in Egypt at this time and to 
establish convalescent hospitals, eventually providing some 
twelve or thirteen auxiliary hospitals. In this way the 



380 MEDICAL HISTORY OF THE WAR 

hospital accommodation in Egypt was expanded from approxi- 
mately 5,000 beds at the beginning of April 1915 to some 
15,000 beds at the time the troops left for the Dardanelles. 

There was, however, a great deficiency of nursing sisters, 
as Nos. 15 and 17 General Hospitals arrived without a nursing 
staff, on the supposition that they would be sent to the Dar- 
danelles. The I). M.S., Egypt, consequently obtained, through 
the goodwill of various authorities, as many nurses as possible 
from civil sources and also the assistance of several ladies 
and a large number of nursing sisters from the Australian 
and New Zealand hospital units, which had brought with them 
ninety- two nurses each, or double the number in a British 
general hospital. Eventually a Principal Matron, Miss Oram, 
arrived on the 10th May 1915, bringing a few nurses with her. 
Shortly afterwards many more were sent from England. 
They were distributed to the various hospitals, and relieved 
the situation. Reinforcements of nursing sisters and members 
of Voluntary Aid Detachments then continued to arrive 
monthly, as well as batches of nurses from Australia and 
New Zealand, so that at the end of 1915 there was a considerable 
surplus of nursing sisters in Egypt. The Khedival Hotel, 
Alexandria, and the Semiramis Hotel, Cairo, were taken over 
for their accommodation. 

Wounded began to arrive from Gallipoli without warning 
between the 29th and 30th April. Seven transports bringing 
a total of 125 officers and 3,221 men came during these days to 
Alexandria. A continuous flow of sick and wounded of the 
British Imperial troops, French and Indians then commenced 
to reach Egypt, and approximately 17,000 were landed by the 
31st May. Hospital accommodation had to be continually 
expanded to meet the requirements ; more especially was 
this the case with No. 1 Australian General Hospital, which 
eventually had some 8,000 beds in Heliopolis, Abbassia and 
Helouan. In these expanded Australian hospitals Arab labour 
was chiefly used for domestic purposes, and the feeding of 
the patients was done by contract with native cooks. This 
extreme expansion of No. 1 Australian General Hospital was 
due to the fact that although the British general hospitals had 
arrived or were arriving, they were not all ready to receive the 
first rush of wounded from the Dardanelles. The four British 
general hospitals, however, were expanded to 1,200 beds or 
more each, and to relieve congestion in them it was decided in 
May 1915 to transfer convalescents to Cyprus, where a camp 
for about 350 was formed. The difficulties of transport, 



MEDICAL SERVICES IN EGYPT 381 

however, were great, and the Cyprus convalescent camp was 
abandoned towards the end of 1915. 

By the end of June 1915, 27,000 sick and wounded, including 
2,000 French wounded, were accommodated in Egypt. They 
were in course of being cleared to Malta, the United Kingdom, 
Australia and India, from Alexandria, Port Said and Suez. 
By the end of July, 31,214 British and 3,000 Indian sick and 
wounded had come to Egypt. 

The Grand Hotel, Helouan, was then taken over and used as a 
convalescent hospital of 500 beds under military commandants. 

The month of August 1915 threw a special strain on the 
hospitals in Egypt. The D.M.S. was always in the dark as 
to what was happening on the Gallipoli peninsula, the strength 
of the troops there, and the proportion of the sick and wounded 
likely to be evacuated to Egypt, but he endeavoured to main- 
tain 10,000 vacant beds for casualties by making full use of 
convalescent hospitals and camps. Yet during August 1915, 
32 transports or hospital ships arrived at Alexandria with about 
20,500 sick and wounded officers and other ranks. Other 
hospitals were then opened, including a large British Red 
Cross Hospital in a building at Gizeh, outside Cairo, and at 
Alexandria a Red Cross Convalescent Hospital was opened 
in the Sultan's Palace at Montazah, in addition to a number 
of small Red Cross hospitals under the auspices of the British 
Red Cross Commissioner, Sir Court auld Thomson. 

A Canadian hospital (No. 5 Stationary) arrived at this 
time in Egypt and opened in the Cavalry Barracks, Abbassia, 
with 400 to 500 beds ; and a military hospital was organized 
in the Nasrieh School in Cairo for some 600 beds. At the 
end of 1918 it was re-designated No. 88 General Hospital. 

From this time onwards till the withdrawal from the Dar- 
danelles, Egypt was flooded with sick, chiefly dysentery and 
diarrhoea patients, just as up till then it had been flooded 
with wounded. 

It was this fact and the large number of troops which came 
to Egypt from the Dardanelles at the end of 1915, suffering 
from dysentery, diarrhoea and epidemic jaundice, that led 
the D.M.S. to appoint Sir David Semple as President of the 
Sanitary Committee* to supervise the Canal area, where a 
large labour corps of natives was being organized. This 
committee developed into a Standing Committee! for the 
inspection of all the military camps in Egypt. 

* Colonel Robinson, I.M.S., Major Lelean, R.A.M.C., Captain Austen and 
Captain Rae were the other members of the Sanitary Committee. 

f Lieut.-Colonel Evan, Sir D. Semple, Lieut.-Colonel Cathcart Garner, 
Major Bagshawe and Captain Austen. 



382 MEDICAL HISTORY OF THE WAR 

Owing to the large number of sick, other hospitals were 
opened in November 1915. Princess Fatima's Palace at 
Boulac, near Cairo, was lent as a convalescent hospital for 
British troops and took some 500 to 600 patients, and some 
of the hotels at Luxor were taken for convalescents. They were 
grouped under the designation " Convalescent Depot," Luxor, 
and accommodated about 100 officers and 2,300 men. This 
depot was some 500 miles by rail from Cairo and hospital 
trains ran there periodically. A large convalescent depot 
was also opened in Abbassia in November 1915. 

Great changes took place in the hospital accommodation 
in Egypt after the Dardanelles Expeditionary Force had 
returned, and after the Anzac Corps and other Corps were 
transferred to France. Additions to the general hospitals 
then were, No. 31 from England at the end of December 1915, 
which opened in Port Said, and No. 27 and No. 3 (Australian) 
from Mudros in February 1916. No. 27 opened in Police 
Schools, Cairo, and No. 3 (Australian) in the Abbassia 
barracks. They replaced No. 1 (Australian) and No. 2 
(Australian) General Hospitals which went to France. No. 8 
Indian and the Bombay Presidency Hospital, as already 
noted, left Egypt in April 1916, after the Indian divisions 
were broken up and the two Indian Divisions from France 
had been transferred to Mesopotamia. A section of No. 5 
Indian General Hospital, which remained, had formed a 
hospital for Indians at Suez in January, which was called 
the Indian Base Hospital, Suez, at the beginning of April 1916. 

When No. 3 (Australian) General Hospital left for France in 
September 1916, it was replaced by No. 14 (Australian) 
General Hospital, which remained in Egypt till the end of the 
war. It was at first at Abbassia, but, as a large Australian 
rest camp had at that time been established at Port Said, 
it eventually replaced there, early in 1918, No. 31 General 
Hospital, which went to Cairo. 

During the period between the withdrawal from the Dar- 
danelles and the operations in the Sinai peninsula, no more 
general hospitals or convalescent depots were opened, but 
several stationary hospitals were added to the Egyptian list 
of hospitals. No. 18, which, however, left for Salonika at 
the end of 1916, and Nos. 24 and 26 arrived respectively in 
January, May and June 1916, and No. 36 in February 1917, 
all from the United Kingdom. No. 36 was opened on the 
sea coast at Mehamdiya in the Romani area, replacing No. 2 
(Australian) Stationary Hospital, which had been transferred 



MEDICAL SERVICES IN EGYPT 383 

there in November 1916. No. 2 (Australian) from the 
Dardanelles and No. 1 (New Zealand) Stationary Hospital 
from Salonika had returned to Egypt in January and 
February 1916, but the latter left for France three months 
later. No. 16 British Stationary Hospital of the Indian 
Establishment was also in Egypt during the first five 
months of 1916. 

When General Sir E. Allenby's operations were in course 
of preparation many additions were made to the number of 
hospitals. In August 1917, No. 69 General Hospital arrived 
in Egypt from the United Kingdom, and four others, Nos. 70 
71, 78 and 87, were organized in Egypt. Four stationary 
hospitals, Nos. 43, 44, 45 and 48, were also formed in Egypt 
at the same time, and a fifth, No. 47, came out from England. 
No. 45 went to Salonika in May 1918, and No. 43 was disbanded 
a month later at the time when Indian troops were replacing 
British. 

Most of the stationary hospitals eventually went to Gaza, 
Mazaid (near El Arish) and Kantara, on the Palestine L. of C, 
and two of the general hospitals, Nos. 69 and 78, to Deir-el- 
Belah. 

In April and May 1918, when the Indian divisions joined 
Sir E. Allenby's Force, seven hospitals, Nos. 39, 41, 44, 45, 50, 
51 and 54 Indian General Hospitals were sent to Egypt from 
India or Mesopotamia. No. 45 absorbed No. 70 General 
Hospital, which was then disbanded. Five were placed on 
the Palestine L. of C, Nos. 41, 51 and 54 at Kantara, No. 39 
at El Arish, and No. 44 at Deir-el-Belah. No. 50 was estab- 
lished at Suez. 

The hospitals and convalescent depots in Egypt during 
the war were thus of an ever varying character. There is 
no definite record of the total number of beds and occupied 
beds in them, week by week, but the following tables describe 
their number and character during the period of the Gallipoli 
campaign, and the approximate number of beds equipped 
month by month in 1915, when the numbers of sick and 
wounded received into Egypt were greatest. The number 
of convalescent camps or depots during that year amounted 
to nineteen. 

The hospitals, which were established in hotels, schools 
and in existing hospital buildings, were equipped with the 
usual general and stationary hospital equipment, but for the 
improvised hospitals the number of bedsteads obtainable in 
Egypt was very limited and native palm wood beds, comfortable 



384 



MEDICAL HISTORY OF THE WAR 









Grand Total 
of beds in 
Egypt. 


d 


CNt^OCDOOOCNCDOOTf 
00TfC75(MO5C^<-H00C£)r^ 

t/5* «M* «* CD* Oi" K CD CD 00* rf* 


o 


COO^CDO>^CNt^gi_i 


Total 
Indian 
beds. 


d 


CNCDUO'-H^HCNiDOCDtN 
OOJCNCN'-hCN^CNCN'-' 

io r»^ oq <o co co_ cq uc cn cd_ 

*-* ~ i-~ CM CN* <N* i-< CN* <N* <N* 


o 


iriioiDioiDi/sioiococs 

COCOCOCOCOCOCO'^*'^ , CO 


Indian 

Convalescent 
beds. 


6 


r^~H©CDCDr-»©05OO 

00 00^00500000 
COTfCDOOOi^O^OOOO 


o 


I 1 1 1 1 1 1 1 1 1 


Indian 

Hospital 

beds. 


6 


ioi/5i/5i/iioioir>.-<a>c<» 

"*- "*. ^ "*. "*. "^ "* "l ^ °°. 


o 


l/5i/5i/5i/5iOi/5l/5l/5COCN 

COCOCOCOCOCOCO'^ ,, 4 , CO 


Total 

British 

beds. 


d 


0<-<iO^C75CDt^COCr)CN 
COiOCDOINUOCTJCDCOCO 
t> CO I> i-« 1/5 r>^ ■«* l> lO CN 

CO* ©" C<" "tf* t>" "<t* Tp" CO* CD* CN* 


o 


©i/500CO*-<©aiCDCD22 
OCDOCNCD^COCNCDg 
CNCOir5U5CD00I>O5O5 t -i 


British 

Convalescent 

beds. 


d 


OtCOCMCCWt>COCN 
1 CO©t-^C75C005a>i/5t > > 
1 ©_ "I. <0_ "* WCCtN —i CD 

~ CN* CN CO* CD* CD* l> CD* <-«* 


id 
o 


1 . ©©TpOOCOOOOOi 
i/5CDCD00OO~tj«<m 


British 

Hospital 

beds. 


d 


Oi-ii-H<Nt^©CNa>CO© 
00CNCDC000CNOCD0005 
l>COCD'<t l ©TCD"<tf , COt/5 
CO* CD* O* »-« Tj* 00* |>" CD* t>" O* 


o 


O^OOCDt^CNCDOOC^O 
OCDi/5CDC)<N©©'-<t^ 

cNco"tt<Tt<uot>rNoooooo 


4 

e 
o 

3 




1st April 1915 

1st May 

1st June 

1st July 

1st August 

1st September ,, 

1st October ,, 

1st November ,, 

1st December 

1st January 1916 



MEDICAL SERVICES IN EGYPT 385 

and strongly constructed, were available in practically un- 
limited number and at a cheap rate. Mattresses, stuffed 
with wool, were also prepared by local contract in unlimited 
numbers and in a very few days. These proved invaluable 
for the rapid expansion of hospitals. A large number of 
mattresses, 2,000, was also sent to the docks at Alexandria 
for use on transports at the beginning of the operations in 
Gallipoli. Blankets, sheets, towels and ward equipment were 
obtained from ordnance stores or by local purchase. An 
immense amount of help was obtained from voluntary sources 
in establishing these hospitals and especially from the 
Australian Red Cross Society, which provided a large number of 
hospital requirements both for British and Australian hospitals, 
and funds with which to purchase additional comforts. 

On the whole, few places presented greater facilities than 
Cairo and Alexandria for establishing hospitals in suitable 
buildings, and it was fortunate that this was so, as otherwise 
hospitals would have had to be pitched under canvas, exposed 
to the sand and dust of the desert, as was the experience in 
Sinai and Palestine. 

Egyptian Hospitals. — A large number of Egyptian hospitals 
was established for the sick and wounded of the Egyptian 
Labour and Camel Transport Corps. They were administered 
by an A.D.M.S., Lieut.-Colonel G. W. Heron, R.A.M.C, and 
were staffed by Egyptian medical officers, medical students 
and hospital orderlies, with a British supervisory staff of 18 
medical officers, a quartermaster and 65 other ranks. The 
Egyptian staff was 62 medical officers or students and 400 other 
ranks. A D.A.D.M.S. was appointed on 1st October 1917 
to assist the A.D.M.S. 

In May 1917 there were 17 hospitals of this class with a total, 
approximately, of 2,500 beds, distributed in various posts 
on the Canal, Sinai L. of C, and in Egypt. The largest units 
were in Kantara (750), Ismailia (450) and El Arish (500 beds). 

There were also sections for 200 prisoners of war in Kantara, 
for 200 at Deir-el-Belah, and for 60 at Port Tewfik. At 
Kantara and El Arish cholera hospitals for 30 and 60 beds 
respectively, and isolation cholera units with 30 beds each 
at Rafa, Deir-el-Belah and Sheikh Nuran were maintained. 

The hospitals were numbered as Egyptian stationary 
hospitals and detention hospitals, and were moved as required 
in conformity with the operations in Palestine. Egyptian 
hospitals were thus brought up in 1918 to Ludd, Jerusalem, 
Jaffa, and elsewhere in Palestine. 



386 MEDICAL HISTORY OF THE WAR 

In 1918 the Egyptian hospitals were greatly expanded. 
Thus in April, No. 6 expanded to 2,000 beds, No. 4 to 1,500, 
and all others to 150 beds each. To meet this expansion 
16 medical officers and 150 medical orderlies were added to the 
staff. 

The Egyptian hospital administration was also charged 
with the control of a segregation compound for 500 at Kantara, 
recruiting depots at Roda Island, Sohag, Assiut and Esna, 
disinfecting plants at Kantara East and West, disinfecting 
railway vans, and various other disinfecting apparatus. 

A convalescent camp for Egyptian Labour and Camel 
Transport Corps and sick and wounded was opened in March 
1918 by the Public Health Department, under whose auspices 
the Egyptian hospitals were established and staffed. This 
convalescent camp moved to Ismailia at the end of the month. 
Convalescent camps were also established at Kantara for 
1,000, and at Ludd, Jerusalem and Jaffa for 500 each. 

All these hospitals received Turkish sick and wounded 
and Turkish interpreters were attached to the staffs. 

The administration of these Egyptian units was reorganized 
in August 1918, when all Egyptian hospitals, and the medical 
and sanitary arrangements of the Egyptian Labour and 
Camel Transport Corps came under the administrative medical 
officer of the Corps, or area of the Palestine L. of C, or Egypt, 
in which they were established or employed. The A.D.M.S., 
Egyptian Hospitals, was then attached to the staff of the 
D.M.S. at G.H.Q., and his D.A.D.M.S. to the staff of the 
Palestine L. of C. Quarantine arrangements, however, re- 
mained under the control of the A.D.M.S., Egyptian Hospitals. 

Another class of hospital, which did much useful work in 
Egypt, were the Government hospitals of the Public Health 
Department. Over 5,000 sick and wounded of the British 
and Dominion forces were received into them during the period 
of the Dardanelles Campaign and the Turkish attacks on the 
Canal. Two tented hospitals, one at Ismailia and the other 
at Suez, were lent to the military authorities as clearing 
hospitals for wounded enemy during these attacks, the equip- 
ment being drawn from travelling ophthalmic hospitals, 
while five permanent ophthalmic hospitals in towns in Lower 
Egypt* were utilized for Imperial, Australian and French 

* Tanta, Mansura, Zagazig, Shebin-el-Kom and Damanhour. The Public 
Health Department hospitals of Upper Egypt at Beni Suef, Fayum, Minia, 
Assiut, Kena and Assouan were also placed at the disposal of the Army and 
were freely used for the reception of the sick from the Western Force. 



MEDICAL SERVICES IN EGYPT 387 

sick and wounded. The clearing hospitals had only received 
116 enemy wounded at Ismailia and 8 at Suez, when they 
were suddenly removed to Port Said on 1st May 1915 for 
the reception of British wounded from Gallipoli. The Public 
Health Department also established a hospital for 550 beds 
under canvas at Alexandria from May to October 1915, with 
a section at Zagazig for Senegalese troops. One hundred 
and fifty beds under canvas were also established at Port 
Said when the clearing hospitals moved from Ismailia and 
Suez. In November these tented hospitals at Alexandria 
(Glymenopoulo), Zagazig and Port Said were combined and 
moved to Gizeh near Cairo under canvas. All these hospitals 
were equipped and manned from various hospitals of the 
Public Health Department. The treatment of the sick and 
wounded in them was carried out by the Egyptian medical 
officers and gave the greatest satisfaction both as regards 
comfort of the patients and results. Approximately over 
100 qualified medical officers and some 40 nursing sisters 
of the Public Health Department, Cairo, gave their services 
to the military authorities during the war in Egypt. 

The administration of the hospitals remained in the hands 
of one of the officers of the Public Health Department 
He commanded the hospital at Glymenopoulo and afterwards 
at Gizeh. 

The Egyptian Government hospital for native patients 
at Kasr-el-Aini, Cairo, under the charge of Dr. F. C. Madden, 
also received sick and wounded. From the 4th February to 
15th April 1915, 166 enemy wounded and 40 enemy sick 
were sent to it. During May and June it received military 
patients, when it reverted to its civil functions ; but was 
opened again for military patients in the middle of July. It 
received sick and wounded continuously to the end of the 
year, the total number being 1,998 wounded and 2,862 sick 
British and Australians from the Dardanelles. 

Reception Stations. — The organization of a reception station 
was peculiar to Egypt. The first reception station was formed 
at Mustapha in August 1915, and continued there till August 
1917, when it moved to Kantara with the various base depots 
of the Egyptian Expeditionary Force, whose place at Mustapha 
was taken by a large " Details Camp " and Command Depot 



388 MEDICAL HISTORY OF THE WAR 

for malarial and light convalescent cases. After the removal 
of the reception station to Kantara its duties were as 
follows : — 

(1) To take all sick parades of the various depots there. 

(2) To examine all drafts arriving from the United Kingdom 

and men discharged from hospitals, in order to ensure 
their cleanliness and freedom from infective diseases ; 
to eliminate all obvious unfits for front line duty, 
particularly amongst drafts from the United King- 
dom ; to examine and register arrivals from hospitals 
and classify them for " temporary base " until they 
were passed by a medical board as fit for front line 
service or otherwise. 

(3) To examine all outgoing drafts for lice or venereal 

disease and weed out unfits. The chief causes of 
unfitness were boils and septic sores. 

(4) To carry out all inoculations for drafts proceeding to 

the front and also inoculate the personnel of sta- 
tionary units near by. 

(5) To prepare all cases for the medical boards. The 

president of these boards was a visiting medical 
officer and the members were provided by the 
reception station. 

The reception station began duty with a staff of 7 medical 
officers and 12 other ranks R.A.M.C. In the beginning there 
was no proper camp for the R.A.M.C. personnel and the work 
of the unit was carried on in two marquees at the entrance 
of No. 24 Stationary Hospital and in one European privates' 
Indian pattern tent (E.P.I. P.) at No. 1 Infantry Base 
Depot. Officers and men were living at various camps in 
the vicinity. In September a definite camping area was 
allotted to the unit and in October the station was opened 
in a self-contained camp. The staff consisted of 6 medical 
officers, 1 dispenser, 11 other ranks R.A.M.C. and 27 "B" 
men* attached. The accommodation was in six marquees, 
one as a Board tent, two together, with an E.P.I. P. tent 
as dressing rooms, and two with 26 beds as " observation 
wards." Later an infectious compound was added and a 
motor ambulance car was attached to the unit. 
A dental depot was also attached to it. 

* " B " men were men fit for duty at the base only. 



MEDICAL SERVICES IN EGYPT 389 

Laboratories. — Mobile laboratories from the United Kingdom 
were not sent to Egypt until April 1918 ; but the Public 
Health Department of Egypt placed a railway car, fitted as a 
bacteriological laboratory, at the disposal of the military 
authorities in April 1915 for use in the Canal Defence Zone. 
In February 1917 it was re-designated No. 5 Military La- 
boratory, at a time when a series of six military laboratories 
was organized for work with the Egyptian Expeditionary 
Force. These laboratories were distributed along the L. of C. 
from Kantara to railhead, attached usually to a casualty 
clearing station or stationary hospital. 

A pamphlet was issued to all medical officers containing 
instructions for a routine method of treatment and diagnosis, 
and, when full use of the stations for the latter purpose was 
made, good results were obtained. They were intended to 
assist medical officers in correctly differentiating malarial 
fevers from other febrile conditions, which might resemble 
malaria and which might consequently lead to a false diagnosis 
and delay in suitable treatment. 

A central base laboratory, organized by Sir David Semple 
in the Hygiene Laboratory of the Public Health Depart- 
ment, was transferred to Kantara. and attached to No. 24 
Stationary Hospital. It was designated the Military Bac- 
teriological Laboratory and supplied all the military field 
laboratories with special bacteriological equipment and trained 
personnel. 

In addition there was an Anzac Field Laboratory which 
was attached to the Desert Mounted Corps. 

Malaria Diagnosis Stations. — In order that severe cases of 
malaria might be early recognized and treated suitably a 
scheme was prepared by Captain P. H. Bahr, R.A.M.C., and 
submitted in February 1918 to the A.D.M.S., Palestine L. of C. 
The scheme suggested the formation of separate units, two 
for each corps, with a staff of specially trained medical officers 
and orderlies, and equipped with two microscopes and other 
necessary medical stores. The D.M.S. sanctioned the forma- 
tion of the units and they were designated " Malaria Diagnosis 
Stations.'' On the 23rd March 1918, seven medical officers 
and sixteen orderlies were posted to No. 3 Military Laboratory 
for a month's course of instruction. At the end of April two 
units were detailed to each corps. Each unit was equipped 
with two bell tents, one E.P.I. P. tent, tables, lamps, two 
microscopes with slides, stains and other equipment. One 
general service wagon carried the unit. 

10134 hh 



390 MEDICAL HISTORY OF THE WAR 

Medical Stores. — The Army Medical Store in Cairo, which 
existed before the war, continued its work throughout. No. 4 
and No. 5 Base Depots were sent out from England in March 
1915, and established at Alexandria. The former became a 
large base depot, the Levant Base Depot of Medical Stores, 
at the end of the year. No. 4 Advanced Depot came with 
and was absorbed by it, till re-mobilized for Palestine in 
August 1917. Until the end of 1915 there were no other 
advanced depots, with the exception of one Indian Depot 
(No. 5)* Nos. 5, 6, 7 and 8 Advanced Depots then came to 
Egypt, No. 8 being shortly afterwards absorbed in the Levant 
Base Depot. Eventually it became a base depot (No. 8) at 
Kantara, and another advanced ,depot, No. 8, took its place 
on the Palestine L. of C. 

The Levant depot supplied medical and surgical stores, and 
equipment for the Dardanelles and Salonika Expeditionary 
Forces. It was replenished from the United Kingdom. The 
army medical store at Cairo supplied the medical units in 
Egypt and the advanced depots during the operations. The 
advanced depots were placed at Suez, Kantara and at railhead 
during the operations of the Eastern Force and Desert Column 
in the Sinai Peninsula. During the operations in Palestine 
they were placed at various points on the L. of C, the most 
advanced being No. 6, which opened at Ludd in February 1918. 
The others were at El Arish, Rafa, Deir-el-Belah and Gaza, 
but were moved from time to time in conformity with the 
military operations. 

In the Alexandria district a central splint factory was 
established at No. 21 General Hospital at Ras-el-Tin. It 
originated in the great demand for splints of all kinds after 
the first landing in Gallipoli, and was commenced by Major 
Hey Groves on 25th May 1915. About 50,000 splints of all 
kinds were issued from this factory and distributed to Egypt, 
Macedonia, Mesopotamia, East Africa and some of the hospital 
ships. A staff of native workmen was employed in manufac- 
turing the splints. Major Hey Groves was succeeded in charge 
of the factory by Colonel Edington who, in his turn, was 
succedeed in July 1917 by Major G. R. Livingstone. During 
the early part of 1917 there was some difficulty with the native 
labourers employed. Up to that time they had been obtained 
through a contractor, but when Colonel Edington took over 
charge he obtained authority to engage men direct, and this 

* No. 5 Indian Depot arrived in January 1915, and opened at Ismailia. 
It left for India a year later. 



MEDICAL SERVICES IN EGYPT 391 

new method of employing labour proved to be very beneficial 
in every way, as no labour troubles subsequently occurred, 
and the men entered whole-heartedly into their work, and 
never failed during strenuous periods. The same difficulty 
was experienced in Egypt as in France with regard to the 
standardization of splints, owing to the demands of individual 
officers to have splints prepared according to their original 
designs or just a little different from standard patterns. The 
officer in charge of the factory prepared a useful illustrated 
catalogue and vocabulary of splints in consequence for the 
information of medical officers, and this was of great use in 
enabling them to obtain splints of a standard pattern to suit 
their requirements. 

The medical services in Egypt owed much to the sympathy 
and help of the High Commissioner, Sir Henry MacMahon, 
Lady MacMahon and many ladies who worked voluntarily 
in the hospitals, especially during the periods when Egypt was 
flooded with sick and wounded from the Dardanelles. The 
Egyptian Civil Medical Service and the Public Health Depart- 
ment were invaluable in many directions, not only in receiving 
British sick and wounded into their hospitals, but in establishing 
and administering, as related above, a series of hospitals for the 
Egyptian Labour Corps, Camel Transport Corps and prisoners 
of war, and in organizing and carrying out extensive sanitary 
work in the camps. Some thirteen convalescent hospitals 
and three convalescent homes were opened by these voluntary 
workers during 1915. The Sirdar also sent, for temporary 
duty under the Director of Medical Services, some twenty 
officers of the Medical Corps of the Egyptian Army, some of 
whom were employed not only in Egypt, but also in Gallipoli. 

Sanitation. 

The sanitation of camps in Egypt and in the areas over which 
operations were conducted caused much anxiety and required 
constant supervision and arduous labour. Waste products 
in the earliest stages were removed by contractors, but there 
was little or no advance in maintaining a high standard of 
sanitation in these camps until incineration was introduced 
and became the recognized method of disposal of all forms 
of waste products. 

Much difficulty occurred at first in the disposal of litter, 
offal, excreta and refuse. All conservancy work of the camps 
along the Canal banks was being carried out by contract, the 
chief camps being Kantara, Ismailia, Moascar near Ismailia, 



392 MEDICAL HISTORY OF THE WAR 

Serapeum, Zagazig and Suez. Later, incineration methods J 
were employed. Vermin were a constant source of trouble. 
Disinfestation was effected by the fixed sterilizers of the 
Public Health Department at Port Said and Suez, and 
by the portable Thresh disinfectors. Eventually, railway 
van disinfectors were brought into use and proved extremely 
useful and efficient. These van disinfectors were introduced 
into Egypt by Colonel W. Hunter in February 1916, as a 
result of his experience of their use in dealing with the 
epidemic of typhus fever in Serbia in 1915. Several were 
subsequently constructed and sent up the Palestine L. of C. 
for the use of divisions and corps in the front. They proved 
invaluable, and Colonel Hunter records that in the first three 
months of their work two double van disinfectors carried out 
the disinfestation of 170,000 kits, 170,000 overcoats, 340,000 
blankets and great masses of ordnance clothing. They were 
the most prominent and effective measure of preventive work 
and by their means 60,000 men of the troops and native labour 
corps could have their clothing disinfected monthly. During 
twelve months, May 1916 to April 1917, amongst an average 
strength of 40,000 labour corps men, 495,000 disinfections 
were carried out. The Serbian barrel disinfector, originally 
designed by Lieut. -Colonel Stammers for use in Serbia in 1915, 
was also largely used in Egypt. A galvanized iron bin dis- 
infector of the same design was subsequently introduced and 
became the recognized means of disinfection by the Public 
Health Department in Egypt and Palestine. 

There was never any difficulty with regard to water supplies, 
for which there were filtration systems from the beginning at 
Suez, Ismailia, Port Said and Zagazig. For the most part 
water was conveyed in pipes, but to the more remote stations 
in water barges. The installation of a chlorinated and piped 
water supply from the Sweet Water Canal to the posts in Sinai 
was a later development, and is fully described in the volumes 
on the Hygiene of the War. 

The sanitation of the camps in the Canal Zone was a source 
of trouble at all times, and required much supervision by the 
administrative and sanitary officers, and eventually by the 
Canal Zone Sanitary Committee. Divisions, units, transports, 
horses and camels, coming and going to and from the 
various camps, added greatly to the difficulty of maintaining 
a high standard of sanitation. At first sanitary sections had 
to be improvised, until definite sanitary sections, such as those 
sent to France, were mobilized for Egypt at a later stage. 



MEDICAL SERVICES IN EGYPT 393 

The improvised sections were on the Indian model and con- 
sisted mainly of sweepers, sent from India. The officers of 
the Indian Medical Service to whom most of the sanitary 
work on the Canal area was entrusted, worked incessantly 
and successfully during 1915 to maintain a high standard of 
sanitation. The introduction of immediate incineration me- 
thods made a vast difference in the disposal of refuse of all 
kinds, and the health of the troops rapidly improved. When 
definitely organized sanitary sections arrived in Egypt men 
of the Egyptian Labour Corps were attached to them. They 
were specially employed in carrying out incineration processes 
and proved excellent workers. 

An exceptionally interesting Medical Exhibition was opened 
at the Nazrieh Hospital in Cairo in March 1919, in which 
were shown a very complete collection of photographs, 
dealing with every medical aspect of the campaign, specimens 
and models of all the means of transport employed, models of 
all the sanitary appliances, and an unique collection of 
pathological diagrams and specimens dealing with the special 
diseases. It was open for four or five days, and special 
leave was given to officers and other ranks to visit it. 



CHAPTER XX. 

THE MEDICAL SERVICES DURING THE OPERATIONS AGAINST 
THE FOLLOWERS OF THE SENUSSI AND SULTAN OF DARFUR. 

THE concentration of the Western Frontier Force at Mersa 
Matruh for operations against the followers of the Senussi 
was complete on the 7th December 1915. The force consisted 
of a composite mounted brigade and a composite infantry 
brigade. The former was composed of three Yeomanry regiments 
of the 2nd Mounted Division, a composite regiment of 
Australian Light Horse, the Notts. Yeomanry R.H.A., and 
ammunition column with auxiliary services ; and the latter 
of three T.F. infantry battalions, the 15th Sikhs, the 1st 
Australian divisional train and a detachment of engineers from 
the Military Works Department of Egypt, with auxiliary 
services. 

Patrols of infantry, the Bikanir Camel Corps, and an 
armoured train guarded the railway line from Alexandria to 
Dabaa, some 70 miles east of Mersa Matruh, and also the 
Moghara Oasis, some 100 miles due west of Cairo. Troops 
were also sent to various posts west of the Nile, to watch the 
approaches to it from the western oases further south. These 
troops formed what was called the Southern Force, as distinct 
from the Western Frontier Force under Major-General Wallace. 

On the 11th and 13th December columns went out from 
Mersa Matruh and encountered the enerrty, retiring afterwards 
to Matruh. The casualties on both days amounted to 1 officer 
and 22 other ranks killed and 8 officers and 66 other ranks 
wounded. 

The force at Matruh was reinforced during December and 
formed into a right and left column. The former, composed 
of cavalry and infantry, was to advance against Gebel Medwa, 
8 miles south-west of Matruh, where 5,000 Senussi were 
concentrated, and the latter, composed of Yeomanry and 
Australian mounted troops, was to make a wide detour and 
cut off the enemy's retreat to the west. A successful action 
was fought on the 25th December, the casualties being 14 
other ranks killed and 3 officers and 47 other ranks wounded. 
The troops then returned to Matruh. 

During the earlier part of January 1916 the operations of 
the Western Frontier Force ceased on account of torrential 



OPERATIONS AGAINST THE SENUSSI 395 

rains, but after the weather cleared up, a column of 5 squadrons 
of Yeomanry, 1 of Australian Light Horse, 2 battalions of 
British infantry, 1 of the New Zealand Rifle Brigade, and 1 of 
the South African Regiment, with artillery, armoured cars 
of the R.N., a British and an Indian Field Ambulance and 
other details, moved out from Matruh on the 22nd January 
and bivouacked for the night at Bir Shola, about 19 miles 
further west. The enemy was then concentrated at a point 
25 miles south-west of Matruh. On the following day the 
column advanced and a fierce action was fought 7 miles out 
from Bir Shola, resulting in the capture and burning of the 
enemy's camp. The casualties in the column were 31 killed 
and 291 wounded. They were brought back to Bir Shola 
with great difficulty owing to the deep mud of the route along 
which they had to be carried. On the 25th January the 
force returned to Matruh. 

The column was then re-organized and its command taken 
over by Major-General W. E. Peyton on 9th February 1916. 
The Composite Yeomanry Brigade became the 2nd Mounted 
Brigade. A composite brigade of T.F. battalions under 
Lord Lucan was formed. The Sikh and New Zealand bat- 
talions were replaced by a South African brigade, and two 
sections of the Hong-Kong and Singapore Mountain Battery 
joined the force. Camel transport was organized with about 
2,000 camels. 

Decisive operations were then undertaken by the Matruh 
Force. The enemy was located at Agagia, some 14 miles 
south-east of Barrani, near Solium. A column moved out 
on the 20th February. On the 24th February it camped at 
Wadi Maktil, where it was attacked on the following day, but 
with a loss to the column of only one man killed and one 
wounded. The enemy was then attacked at Agagia and a 
battle, resulting in his complete defeat, was fought on the 26th 
February. The column then marched to Barrani without 
opposition. The whole of General Peyton's force assembled 
there from Matruh on the 8th March, and advanced by the 
coast route to Solium, which was re-occupied on the 14th of 
the month. Information was then received that the crews 
of the torpedoed ships were at a place some 75 miles west of 
Solium. Armoured cars accompanied by motor ambulance 
cars went out and rescued them without loss. 

On the 23rd November 1915 Lieut.-Colonel E. P. Sewell, 
R.A.M.C, was appointed A.D.M.S. of the Western Frontier 
Force. His D.A.D.M.S. (for Sanitation) had already proceeded 



396 MEDICAL HISTORY OF THE WAR 

on reconnaissance of camp sites and water supply at Mersa 
Matruh together with the 15th Sikhs and a section of No. 137 
Indian Field Ambulance. The other medical units appointed 
to accompany the force were the Notts, and Derby Mounted 
Brigade Field Ambulance, and the 1/lst South Midland 
Mounted Brigade Field Ambulance. The former was attached 
to the Infantry Column and the latter to the Cavalry Column. 
As the operations were to be conducted against tribes not 
likely to respect the medical services, all R.A.M.C. personnel 
were armed. The coastguard ship " Raschid " was taken 
over and equipped as a hospital ship at Alexandria. Trawlers 
had been considered for the purpose but were unsuitable. 
Arrangements were also made for sick to be brought back on 
the trains running between Alexandria and Dabaa, a N.C.O., 
R.A.M.C, being permanently placed on each train to arrange 
for their reception and take charge of them during evacuation 
to Alexandria. After organizing the chlorination of wells 
along the land route to Matruh, Colonel Sewell left Alexandria 
for the latter place by rail and car on the 10th December. The 
road from Dabaa to Matruh was bad with deep sand in many 
places, and the transport moved slowly and with difficulty. 

During the fighting 14 miles west of Matruh on the 11th 
December the wounded were received into the Notts, and 
Derby Mounted Brigade Field Ambulance, a section of which 
was then at Matruh, having proceeded there by sea on 27th 
November. The wounded were embarked the next day on 
the coastguard cruiser " Abdul Monayon." The total number 
of wounded received at Matruh was 18, including 3 officers. 
The field ambulance had been opened with 50 beds in a large 
shop conveniently near the road and landing stage. 

The South Midland Mounted Field Ambulance at this time 
was in scattered parties along the road, but part of the 
personnel, five light ambulance wagons and medical stores were 
at Matruh. The section of No. 137 Indian Field Ambulance 
occupied an Egyptian hospital building of fourteen beds. 

The field arrangements that had been made for the opera- 
tions of the 11th November were for the bearer divisions 
of the Notts, and Derby Field Ambulance and the Indian 
Field Ambulance sections to proceed with the force with 
three ambulance wagons, for a trawler to stand in close to the 
shore, and for motor-cars to work along the road to pick up 
wounded. 

During the attack of 13th December near Ras Um Rakhum 
on the British force which remained there after the fighting 



OPERATIONS AGAINST THE SENUSSI 397 

two days previously, two trawlers were sent out with a medical 
officer, five orderlies, and medical and surgical supplies on 
each. The trawlers returned on the morning of 14th December 
with 48 wounded, including 5 officers. The " Raschid " 
hospital ship arrived just as the wounded were about to be 
transferred to the field ambulances on shore, and the wounded 
and some sick were embarked direct on it for Alexandria, 
Six motor ambulance cars arrived the same day in response 
to a wire from the A.D.M.S. to the D.M.S., Egypt. They 
were employed with cavalry reconnaissance parties. 

In the operations of the 25th December, when a column 
went out against the enemy at Wadi Merghib, eight miles 
from Matruh, a section of No. 137 Indian Field Ambulance with 
four sand carts, and the Notts, and Derby Field Ambulance 
bearer division with five light ambulance wagons accompanied 
the main body, and the South Midland Field Ambulance 
bearer division with five light ambulance wagons the Mounted 
Column. The ambulance wagons with the main body could 
not move off the Khedival road, on account of the exceedingly 
rough character of the ground, but they were sent forward to 
a point as near the action as possible, wounded being brought 
to them on stretchers or by the sand carts of the Indian field 
ambulance. The sand carts proved invaluable and picked up 
the majority of the wounded. The Indian field ambulance had 
opened a small dressing station under Major Seely, I.M.S., 
behind a ridge on which the guns were placed, and a large 
number of the wounded passed through his hands. Colonel 
Sewell, who was with the main body, ordered the motor ambu- 
lance cars to come up to the point on the road, which had been 
reached by the ambulance wagons, and to which the wounded 
were being brought. As each car was loaded it went off to 
Matruh, and in this way 50 wounded were brought to Matruh by 
the afternoon. The ambulance wagons were practically not used. 

Several wounded had still to be collected after the force 
had retired to bivouacs for the night, but eventually all were 
brought in. 

The ambulance wagons with the Mounted Column kept in 
close touch with the troops, but the A.D.M.S. sent out three 
Ford cars of the R.N. Armoured Car detachment along the 
road towards midday, and brought the wounded back, of 
whom there were only four. 

The total number of wounded brought to Matruh was fifty- 
two. All except the very slight and very seriously injured 
were embarked on the hospital ship the next day. 



398 MEDICAL HISTORY OF THE WAR 

Colonel Sir Victor Horsley arrived as Consulting Surgeon 
on the 29th December and left on the 31st December, 
having been summoned to see a seriously wounded case. 

The chief want felt by the medical services during this 
battle was the need of pack transport, and consequently on 
the 27th December six pairs of camel cacolets were issued 
and fitted on camels. 

On the 28th December the column, which went out to 
Jeraula, bivouacked there for the night and the following 
morning advanced against the enemy position, twelve miles 
further south. It was accompanied by the 1/lst South Midland 
Mounted Field Ambulance, less a tent sub-division, 10 light 
ambulance wagons and 6 camels with cacolets, and by the bearer 
sub-division of the section of No. 137 Indian Field Ambulance 
and 4 sand carts. Lieut. -Colonel T. H. Forrest, R.A.M.C. 
was appointed to act as S.M.O. of the column. His orders 
were to bring the casualties to Jeraula, where they would be 
taken over by the motor ambulance cars and brought to 
Matruh. The column returned to Matruh on the 30th 
December without having seen any of the enemy. The long 
march over rough ground, however, caused a number of men 
to fall out with blistered feet, and 143 had to be carried back 
in the ambulance transport. The motor ambulance cars, 
which were sent from Egypt, proved useless for work on the 
rough roads. The springs became flattened, the frames bent 
and the bodies loose. Consequently, application was made 
to the D.M.S. for Ford cars with light ambulance bodies to 
replace the heavier cars. Fourteen more pairs of camel 
cacolets arrived on the 2nd January 1916, so that the A. D.M.S. 
had then at his disposal 20 pairs of camel cacolets for 8 lying 
and 32 sitting patients. 

When the column moved out again on the 12th January 
1916 after a period of heavy rains it was accompanied by the 
1/lst South Midland Mounted Field Ambulance (less a tent 
sub-division) with 5 camels and cacolets, and 3 stretcher 
squads of No. 137 Indian Field Ambulance and 4 sand carts, 
under Lieut.-Colonel Forrest as S.M.O. An operating centre 
was established in a house at Matruh. The column returned 
without casualties on the 16th January, but sixty-four footsore 
and unfit men had to be carried. 

On the 17th January the 2nd East Anglian Field Ambulance 
and No. 54 Casualty Clearing Station were ordered to join 
the Western Force. 



OPERATIONS AGAINST THE SENUSSI 399 

On the 22nd January the column moved to Bir Shola, 19 
miles westwards along the Khedival road. The medical 
units with it were the 1/lst South Midland Mounted Field 
Ambulance (less a tent sub-division) with 10 light ambulance 
wagons, and " A " Section of No. 137 Indian Field Ambulance 
with its 4 sand carts. The 6 heavy ambulance cars and 6 
Ford cars were sent to join it on the following day. During 
the battle, which ensued on the 23rd January, it was im- 
possible to form a dressing station under cover as the ground 
was quite level and no shelter could be found. The dressing 
station had consequently to work under rifle fire. Only one 
of the heavy ambulance cars could come up, the remainder 
had stuck in the mud near Bir Shola. The wounded were 
then sent back in the Ford cars and transferred to the ambul- 
ance cars at Bir Shola at first, but on the second journey back 
the Ford cars went on to Matruh without transferring wounded 
to ambulance cars. As the fighting line advanced the dressing 
station was now further back out of the fire zone. The 
wounded were brought to it by the light ambulance wagons 
and sand carts, which went as close to the firing line as possible 
and picked up the casualties collected by the stretcher bearers. 
When fighting ceased at 5.30 p.m. all the wounded had been 
collected, but a difficult problem had then to be faced. The 
motor ambulance cars and wagons, which had been relied on 
to evacuate the wounded, failed to come up, owing to the 
state of the roads, and only the 10 light ambulance wagons 
and the 4 sand carts were available for carrying about 250 
wounded. The G.O.C. then decided to bivouac on the spot. 
The wounded were made as comfortable as possible for the 
night under such shelter as could be provided. It rained 
heavily, and early in the morning evacuation of the wounded 
commenced. There were 70 lying down cases and all had 
to be carried by hand. Those able to ride, some 100, were 
carried on cavalry horses, and the remainder were loaded on 
to the ambulance wagons, limber wagons, gun limbers and 
ammunition carts. The progress was very slow owing to the 
heavy mud, the pace being only about one mile an hour. After 
five hours the train of supply wagons was met. The sitting 
cases were transferred to them, and the stretcher cases to the 
ambulance wagons, and in this manner the first bivouac was 
reached. On the 25th January the march was continued. 
Ford cars came up and brought the wounded to the point on 
the road where the motor ambulance cars were assembled. 
By 5 p.m. all had been brought in to Matruh, where the hospital 



400 MEDICAL HISTORY OF THE WAR 

ship was waiting. The total number of wounded in this 
action was 261, of whom 10 were British officers, 3 Indian 
officers, 150 were British other ranks and 99 Indian other 
ranks. Ninety-seven of the wounded were evacuated on the 
26th January by the hospital ship, and 23 on a transport, 
the " Messir." The hospital ship returned and evacuated 
103 sick and wounded on the 28th January. 

Colonel Sewell went back to Alexandria on the hospital ship 
to discuss future medical requirements with the D.M.S. and 
arranged for a supply of 20 sand carts, 50 pairs cacolets, and 
a stationary hospital to be sent to Matruh. No. 16 Stationary 
Hospital arrived according to this arrangement on the 31st 
January. It opened for work on the 11th February 1916, 
on which day Major-General Peyton assumed command of 
the Western Frontier Force at Matruh. On the 13th February 
a small force proceeded along the coast to establish an advanced 
base at Unjeila, 40 miles west of Matruh. A tent sub-division 
of the Notts, and Derby Field Ambulance accompanied it. On 
the 20th February the column left Matruh to advance to 
Barrani, 40 miles west of Unjeila. Both the South Midland 
and Notts, and Derby Field Ambulances went with it, the 
former to accompany the column beyond Unjeila and form 
a dressing station in the event of any battle taking place, 
and the latter to establish a casualty clearing station at 
Unjeila. All the transport of the Notts, and Derby Field 
Ambulance, 64 pairs of camel cacolets for 40 lying and 88 
sitting patients, and 20 sand carts, were to accompany the 
South Midland Field Ambulance. The six motor ambulance 
cars were to work between Unjeila and the battle area, along 
the Khedival motor road to Solium. 

During the ensuing action of Agagia on the 26th February 
a dressing station was established behind a small hill. The 
motor ambulance cars were brought up to it, and the sand 
carts worked between it and the battle front, over an area 
about a mile in depth. The fighting ended at 1.30 p.m. with 
the flight of the enemy, and at 4 p.m. the ambulance cars 
left with 34 wounded for Unjeila, a distance of 50 miles, of 
which 47 were by road and 3 across country. In the cavalry 
charge 33 of the British who fell were instantly killed by the 
enemy, but 24 wounded were collected by the regimental 
medical officers and brought to the field ambulance the 
following day, when 70 wounded were taken on to Unjeila 
in two journeys of the ambulance cars. More sick and wounded 
were placed in the cars next day and sent back to Matruh. 



OPERATIONS AGAINST THE SENUSSI 401 

The South Midland Field Ambulance was then moved up 
to Barrani. 

The hospital ship " Raschid " was ordered to Unjeila and 
arrived early on the 27th February. An attempt was made 
to embark wounded on it, but owing to the heavy sea only 
five could be got on board. The following day the ship came 
closer in shore and eighty-six patients were taken on board 
before embarkation had to be abandoned on account of the 
rough sea. The embarkation was effected with great difficulty 
and risk, the ship's crew making twenty journeys to the shore 
and back in the boats. The patients that could not be em- 
barked were taken to No. 16 Stationary Hospital, Matruh, 
in the motor ambulance cars. 

Barrani now became the advanced base for further opera- 
tions and the Notts, and Derby Field Ambulance was moved 
to it from Unjeila on the 6th March. A detachment of No. 16 
Stationary Hospital was ordered up to Barrani and opened 
a 100-bedded hospital there on the 11th March. It arrived 
in the hospital ship on the 7th March. Arrangements had 
been made for the operations which commenced on the 9th 
March. The infantry brigade moved from Barrani that 
day accompanied by the Notts, and Derby Field Ambulance, 
with 18 sand carts, 11 camels with litter cacolets, and 50 with 
cacolets for sitting cases. On the 11th March the Mounted 
Brigade moved off accompanied by the South Midland Field 
Ambulance with 12 light ambulance wagons and 50 pairs of 
cacolets on camels. 

The columns reached Solium on the 14th March 1916, 
without opposition. On the 16th March the motor ambulance 
cars were brought up with great difficulty to the plateau above 
Solium, and took part in the rescue of the British prisoners 
by the armoured cars on the following day. Ninety-one 
prisoners were brought back and transferred at the top of the 
pass to cacolets on camels. They left for Alexandria on the 
" Raschid " on the 19th March. 

A detachment of No. 16 Stationary Hospital was brought 
up to Solium on the 17th March. On the 29th March the 
Force, having accomplished its object, was dissolved. 

The Medical Services with the Egyptian Southern Force. 

The Southern Force Command was formed under Major- 
General W. E. Peyton on 20th January 1916, with headquarters 
in the Kasr-el-Nil barracks, Cairo. The force consisted of 
the 53rd Division and attached troops ; 1st Australian Light 



402 MEDICAL HISTORY OF THE WAR 

Horse Brigade, North Midland Mounted Brigade, Dismounted 
Brigade (Highland with the Scottish Horse), and a detachment 
of the Bikanir Camel Corps. They were distributed to various 
posts in the Nile Valley — at Wadi Natrun, Wardan, Fayum, 
Minia and Mena. The South Western Mounted Brigade 
(dismounted) joined the force in March and took the place 
at Minia of the Highland Mounted Brigade which moved 
south to Sohag and Assiut. Another dismounted brigade 
of the Welsh Border and South Wales Yeomanry with the 
Welsh Border Mounted Field Ambulance, also joined the 
force towards the end of March, and went to Wardan. 

Colonel R. H. Luce, A.D.M.S. of the 2nd Mounted Division, 
was appointed A.D.M.S. of the Force, with Major G. C. Taylor 
as D.A.D.M.S. 

The medical units were as follows : — 

Scottish Horse Field Ambulance . . . . Mena. 

1st Highland Mounted Brigade F.A. .-. . . Sohag. 

North Midland Mounted ,, ,, . . . . Fayum. 

Field Ambulances, 53rd Division . . . . Wadi Nat- 

run and 
Wardan. 

Australian Light Horse F.A. . . . . . . Wadi Nat- 

run. 

South Western Mounted Brigade F.A. . . . . Minia. 

No. 53 CCS. attached to Command . . . . Wardan. 

There were Government hospitals at Fayum, Minia and 
Beni Suef, where the headquarters of the Force moved from 
Cairo on 17th February 1916, and where Lieut. -Colonel Leiper 
was attached for duty in connexion with investigations into 
bilharziasis. His laboratory was in the Kasr-el-Aini Hospital, 
Cairo. 

State hospitals at various other posts, such as Assiut, Sohag, 
Kena, Esna and Assouan, were also gradually opened for the 
reception of British sick and wounded as the force took up 
positions from north to south in the Nile Valley. The arrange- 
ments, which had already been in existence in other parts of 
Egypt, for the use of the State hospitals prevailed. A certain 
number of beds was placed at the disposal of British troops in 
each hospital according to estimated requirements. The 
administration remained entirely in the hands of the Egyptian 
Principal Medical Officer, but where it was convenient an 
English nursing sister was appointed as matron with the neces- 
sary staff of nurses under her. A R.A.M.C medical officer 



OPERATIONS IN SOUTHERN EGYPT 403 

was attached to each hospital with a personnel of R.A.M.C. 
orderlies as required. The R.A.M.C. medical officer had 
medical charge of all British soldiers and was responsible 
for the discipline of patients and orderlies. The R.A.M.C. 
personnel, both officers and men, was furnished from the 
various field ambulances with the Force. 

On 2nd March 1916 troops were moved to the Assiut area, 
and camps were formed at Minia, Deirut, Assiut, Sohag, 
Girga and Luxor along the Nile Valley railway. 

At the beginning of April the Southern Force was merged 
into the Western Frontier Force, on the completion of the 
Solium operations by the latter, and Colonel Luce then became 
A.D.M.S. Western Force, with Major C, P. Thompson as 
D.A.D.M.S., and Major Taylor as Sanitary Officer. Major 
Thompson only remained a short time as he was recalled for 
duty with the Public Health Department a fortnight later, 
Major Taylor taking his place as D.A.D.M.S. The head- 
quarters returned to Cairo from Beni Suef , and Solium, Matruh, 
Dabaa and Hammam became stations in the Command. 

The only other medical unit then added to the Force 
was No. 16 Stationary Hospital, which had detachments at 
Solium, Matruh and Dabaa. The Force was divided into 
two subordinate commands, a Northern consisting of the 
Western Coastal area, Wadi Natrun, Fayum and the Nile Valley 
as far as Minia, and a Southern, consisting of the Nile Valley 
south of Minia. An A.D.M.S., Lieut. -Colonel Evatt, ad- 
ministered medically the Northern section, and a S.M.O., 
Lieut. -Colonel J. W. Mackenzie, the Southern section. 

A Governor of the Western Frontier was appointed, with 
Major McAllan, R.A.M.C, as his- principal medical officer at 
Matruh. 

There was little activity on the Western front subsequently, 
but various changes in the medical units took place. 

No. 53 CCS. left the force in May 1916 and No. 54 joined it 
in September 1916. The medical arrangements consisted of 
the establishment of a series of hospitals in the Nile Valley, 
including No. 54 CCS., which went to Minia. It left, however, 
on the 3rd December 1916 for the Canal Zone. Field ambul- 
ances equipped with desert ambulance transport were attached 
to the columns moving to the Western oases, and railway 
coaches were fitted for sick and wounded on the railways 
running westwards from the main line in the Nile Valley. 
The field ambulances also opened camp hospitals for treatment 
of slighter cases at all the principal camps. These hospitals 



404 MEDICAL HISTORY OF THE WAR 

were tented except in one or two instances when reed huts 
were constructed. Cases requiring special or prolonged treat- 
ment, and all venereal cases, were sent to the general hospitals 
at Cairo. During the hot weather a considerable number of 
men were also sent to convalescent hospitals in Cairo. 

For evacuation of sick from the field ambulance camp 
hospitals to the State hospitals, and from the State hospitals 
to Cairo, full use was made of the railways. On each of the 
oases railways, namely on the Wadi Natrun and Kharga lines, 
an improvised hospital coach was in use. These coaches were 
formed by fitting up a passenger coach with stretchers sup- 
ported on slings according to Zavodovski's method. Each 
coach took twelve patients arranged in two tiers, and this 
allowed for a small area at one end of the coach where water, 
medical comforts, and dressings could be stored, and where 
warm drinks could be provided by means of a Primus stove. 
One R.A.M.C. orderly was in charge of the coach. On the 
main line a similar coach was used for collecting sick and 
conveying them to the hospitals at Sohag and Assiut. Another 
similar coach was employed regularly on the coast line between 
Dabaa and Alexandria to evacuate the sick from the various 
posts along that line. Sitting cases were evacuated by 
ordinary trains. On four different occasions one of the regular 
hospital trains was used in time of pressure to evacuate the 
accumulations of sick from the State hospitals. From the 
coastal stations of Matruh and Solium sick were evacuated by 
the hospital ship " Raschid." 

In the local conveyance of sick motor ambulance cars were 
used in Fayum and in the larger towns of Minia and Assiut 
where there were fair roads. The local roads of Upper Egypt 
were almost entirely made along the sides of the irrigation 
canals. Mud from the bottom of the canals was used to make 
these roads. When dry and carefully supervised they made 
fair motor roads, but in wet weather they were quite im- 
passable for motor traffic . In the actual desert, cars could 
be used with great advantage, but the surface varied greatly 
in different districts, and also in different parts of the same 
district. In many parts there were wide stretches of the 
best possible going, in others where the limestone was near 
the surface, and where the sand had been swept off it, it was 
very stony and damaged the tyres. In other places where 
the sand had drifted the cars often stuck in the soft sand. For 
desert work it was found necessary to have cars with high 
axle clearance and high engine power relative to weight. The 



OPERATIONS IN SOUTHERN EGYPT 405 

expedient of carrying four long boards with bevelled ends on 
to which the wheels of the car could be lifted when stuck in 
soft sand proved a most effective method of extricating them 
from difficulties . On the whole it was proved by experience 
that there were few parts of the western desert which could 
not be made accessible to motor ambulance cars. It was, 
however, sometimes necessary to make long detours to find a 
practicable road. 

All the medical units were equipped with sand carts and 
camel cacolets for transport of sick. Sand carts were most 
useful where motor cars could not go. There was little need 
to have recourse to camel cacolets for the routine work of 
evacuating sick. For the expeditions which were prepared 
for the advance to Baharia and Dakhla, cacolets were provided 
in considerable number, as it was doubtful if motor ambulance 
cars could be got through the sand dunes which bar the roads, 
and the carrying of water for mules necessitated the cutting 
down of mule-drawn sand carts to a minimum. An attempt 
was made to apply camel draught to sand carts, but it was 
not very satisfactory. Ordinary ambulance wagons were 
useless for desert work, but were used in some parts of 
Upper Egypt where the roads were too bad for motor 
ambulance cars. 

The troops on the whole were healthy. The percentage 
of ration strength admitted to hospital weekly varied for the 
whole force from 1-5 per cent, to 3- 1 per cent., but the highest 
local records reached 12-93 per cent, and 8-9 per cent at one 
time, owing to a very extensive outbreak of sandfly fever at 
Assiut and Minia, the symptoms resembling influenza. On 
the whole the troops stood the hot summer in camp remarkably 
well. Their general condition and moral suffered very little, 
though it was thought that European troops would not be 
able, to stand the heat of Upper Egypt in summer. The men 
were worked very lightly, and orders were issued that no 
avoidable duty should be carried out between the hours of 
9 a.m. and 5 p.m. during the summer months. 

The Western Force was amalgamated with the Delta District 
to form the Delta and Western Force District on 15th March 
1917. Colonel Luce had left the Force a month earlier to take 
up the appointment of A.D.M.S., Imperial Mounted Division 
in the Eastern Force, Desert Column, and his D.A.D.M.S., 
Major G. C. Taylor, was then left in administrative charge. 

The medical situation may be followed by reference to the 
sketch map in the previous chapter. 

(10134) II 



406 MEDICAL HISTORY OF THE WAR 

The Medical Services during the Operations against the Sultan 

of Darfur. 

The Darfur operations were conducted by a force of 165 
officers and 3,079 other ranks. The medical personnel were 
5 British and 10 Egyptian officers and 93 other ranks of the 
Egyptian Army Medical Corps. Major A. G. Cummins, 
R.A.M.C, accompanied the column as A.D.M.S., and Captain 
C. Cassidy was in medical charge of the advanced troops. Two 
sections of an Egyptian field hospital, a casualty clearing 
station, and a section of a Camel Box Field Hospital* of the 
Egyptian Army organization, formed the medical units of 
the force. Each of the battalions or other units had two 
panniers. 

aaa/nst theSu/tan ofDarfur/9/6. 



SceiBefmfcs. Khart0 



tOO 50 O IOO 

f-ll lr | l lll | k- 



Meut./mw/*/ 






!i_Nahuo. 
(Advanced BaseJ. 



Route fo/lowed by th* cofomn — — — 




In the first phase, the occupation of Um Shanga and Jebel- 
el-Hilla, a detachment of one of the field hospital sections 
with two Egyptian officers and ten other ranks accompanied 
the Force. An Egyptian officer had medical charge of the 
Camel Corps with a pair of panniers. Medical Corps orderlies 
with haversacks were with the Camel Corps companies and 
with the artillery, engineers and mounted infantry detachments. 
The casualty clearing station was at the advanced base El 
Nahud, about 150 miles from railhead. All medical personnel 
and equipment were carried on trotting camels. 

During the second phase, involving the occupation of the 
line of wells from Jebel-el-Hilla to Abiad, the remaining field 

* The Egyptian Field Hospital was a recent organization, in which the equip- 
ment was in light loads of 50 lbs. each, capable of being carried by bearer or 
pack transport. The Camel Box Field Hospital was the old organization 
with equipment in heavy loads in boxes 150 lbs. each for camel transport 
only. 



OPERATIONS AGAINST DARFUR 407 

hospital section and the casualty clearing station were moved 
up to Jebel-el-Hilla. The sick were evacuated to the Camel 
Box Hospital Section, which was transferred from the railhead 
at El Obeid to El Nahud. During the advance a complete 
field hospital section with one British and two Egyptian officers 
accompanied the column. 

The final phase, terminating in the occupation of El Fasher, 
required a special medical organization. A British maxim 
gun section manned by men of the R.G.A., a detachment of 
mounted infantry, three batteries of artillery, four companies 
Camel Corps, a Sudanese and Arab battalion formed the 
force. The medical unit was one field hospital section. An 
Egyptian medical officer and eight orderlies of the Medical 
Corps were attached to units, and a R.A.M.C. orderly to the 
maxim gun section. 

A section of a field hospital was brought up from El Obeid 
to El Nahud, and the Camel Box Section from El Nahud to 
Jebel-el-Hilla, relieving the casualty clearing station there, 
which was advanced to Abiad. Major Parsons Smith, R.A.M.C, 
was placed in charge of all medical arrangements along this 
line of communication. It was arranged that the casualty 
clearing station should move to El Fasher whenever it was 
occupied and set free the field hospital section for further 
operations with the column. 

Camel transport was used entirely for personnel and equip- 
ment. Camel cacolets and wheeled stretchers were employed 
as ambulance transport. The wheeled stretchers were drawn 
by camels, for which a simple form of harness was devised. 
One camel could pull unloaded two of the wheeled stretcher 
carriers, which thus formed a four-wheeled vehicle. A spare 
camel was led with it, to be harnessed to one of the carriers 
when loaded. 

During the action of Beringia, which was fought on 22nd 
May, the day before the column entered El Fasher, the medical 
units were in the centre of the square formation.* Tents were 
rapidly pitched, and within twenty minutes after the fighting 
had ceased all the wounded were under cover and attended to. 
The numbers of wounded were 1 British and 2 Egyptian officers 
and 18 other ranks. Two of the rank and file were killed. 
All the wounds were caused by solid lead -450 bullets fired 
from a Remington or Gras type rifle. There was only one 

* In the centre of the square the ground fell to a hollow, and the field 
hospital was thus well under cover, although the tops of the tents, which were 
exposed, were riddled with bullets. 



408 



MEDICAL HISTORY OF THE WAR 



case of subsequent suppuration. The wounded were taken 
on in the wheeled stretcher carriers and cacolets to El Fasher, 
and a hospital established there in buildings. On the 26th May 
the casualty clearing station came up from Abiad, and a 
large number of enemy wounded were brought in and treated 
in it. About fifty were serious cases and in a septic condition. 
The enemy had been in massed formation about 12,000 strong, 
and had attacked the square on two 'faces, many coming to 
within 20 yards of it. 

These successful operations were carried out over a waterless 
tract of country, consisting of open rolling downs with scattered 
bush. The surface, never very hard, became heavy and loose 
in places, rendering marching slow and tiring. In some 
areas the bur of the " heskaneet," a thorny grass, got into 
puttees, blankets and socks, the small thorns entering the 
skin and giving rise to localized abscesses. 

The weather was very hot, but few men fell out on the 
march. Water was the chief difficulty, only six quarts daily 
for each man being allowed for all purposes on the line of 
march. One difficulty arose from the water in the metal 
water-bottles becoming too hot to drink. 

The Maxim Section consisted of fifteen rank and file, all 
old British soldiers, with previous experience of service in hot 
climates. They were mounted on trotting camels. No 
serious disease occurred amongst them, but minor ailments 
such as diarrhoea and mild fevers were common. 

The rations were good and sufficient, fresh meat being 
available at all times. A field force canteen was brought up 
and luxuries such as sugar and tobacco could then be purchased. 
One ounce of lime-juice was issued twice weekly when fresh 
vegetables were unobtainable. 

The sick statistics were as follows : — 





March. 


April. 


May. 


Number of admissions 

Average daily sick 

Percentage daily sick to strength 


92 

27 

1-38 


115 

47 

2-19 


172 

73 

2-64 



The Camel Corps had the largest number of admissions, 
chiefly on account of venereal disease, which accounted for 
nearly half of the sickness. 

In the Arab battalion there was a considerable amount of 
pneumonia, but otherwise the health of the men was excellent. 
This battalion had neither blankets nor ground sheets, and the 
medical officers attributed the incidence of pneumonia to this. 



CHAPTER XXI. 

THE MEDICAL SERVICES DURING THE OPERATIONS IN THE 
SINAI PENINSULA. 

UNTIL the Egyptian Expeditionary Force was formed after 
the withdrawal from the Dardanelles in 1916, no operations 
were conducted with a view to driving the enemy out of the 
Sinai Pensinsula. On the other hand, enemy forces approached 
the Suez Canal from time to time, and the medical arrangements 
in this area were concerned with the provision of medical 
assistance at the various defensive posts along the Canal 
banks, and with the organization and supervision of sanitary 
services. 

The medical units during this early period were the field 
ambulances, which came from India in November and December 
1914 for service with the two new Indian divisions, the Indian 
Imperial Service Cavalry Brigade and the Bikanir Camel Corps. 

When it was known that a large body of the enemy had 
entered the Sinai Peninsula early in January 1915, medical 
preparations were made for the impending attack on the Canal. 
The Indian field ambulances, or sections of them, were dis- 
tributed to the various defensive posts. They were provided 
with camel cacolets and sand carts for ambulance transport, 
to enable them to accompany the patrols. Barges for con- 
veyance of wounded were prepared at Port Said under Major 
Heron, of the Egyptian Medical Service. 

Wounded in No. 1 Section of the Canal Defences were to 
be taken to the Civil Hospital in Suez, in No. 2 Section by 
launch or rail to Ismailia, and in No. 3 Section by launch or 
rail to Port Said. The three hospital trains were in garage, 
one at Port Said and two at Zagazig. No. 4 Train, manned 
by personnel from one of the Indian General Hospitals, was 
kept at Cairo. 

A clearing hospital of 100 beds for Indians was organized 
at Ismailia by a section of No. 5 Indian General Hospital, 
and another for Dominion, British and naval units by the 
Australian Clearing Hospital. At Port Said there were two 
sections of one of the Indian field ambulances and an Australian 
stationary hospital. 






410 MEDICAL HISTORY OF THE WAR 

Two clearing hospitals were prepared by the Egyptian 
Public Health Department, one at Ismailia and one at Suez, 
for wounded Turkish prisoners, as noted in Chapter XIX. 

During the attacks on 3rd and 4th February 1915, the 
number of wounded was comparatively small. They were 
all cleared to Ismailia and from there by train to Cairo. 

During the remaining months of 1915 the chief work of the 
medical services in the Canal Zone was in connexion with 
the sanitation of the camps, the reception of Indian sick and 
wounded from France and the Dardanelles, and their eva- 
cuation in hospital ships or transports from Suez to India. 
For administrative purposes the 10th and 11th Indian Divisions 
were amalgamated, and the staff for medical services then con- 
sisted of Colonel Robinson, I.M.S., as D.D.M.S., Lieut.-Colonel 
Burden, I.M.S., as A.D.M.S., Captain Whitworth Jones as 
D.A.D.M.S., and Major Graham as D.A.D.M.S. (Sanitation). 

There was much difficulty in maintaining a good standard 
of sanitation in the camps. The sick-rate was high, especially 
on account of dysentery. 

The personnel of the Indian field ambulances was constantly 
depleted to find reinforcements for Indian medical units in 
the Dardanelles, and to supply staffs for transports employed 
as carriers of sick and wounded, and, generally speaking, the 
Indian medical units were nearly disorganized by this dis- 
tribution of their personnel and also by sections of some being 
transferred to places widely apart, such as the Western frontier 
in Egypt, the Dardanelles and Salonika. 

Congestion in the Indian hospitals was great, owing to the 
programme of evacuation to India being irregularly carried 
out, and the number of hospital ships available being in- 
sufficient. The reinforcement drafts from India and Australia 
brought with them many men who were suffering from diseases 
or otherwise unfit for service, and these too added to the 
congestion in the medical units. A convalescent camp for 
Indians was consequently established at Suez to relieve the 
hospitals. 

During July 1915, when Indian brigades were transferred 
to Aden, Mesopotamia and the Dardanelles, two weak 
Indian brigades and the Bikanir Camel Corps were the 
only Indian formations left on the Canal. The gaps were 
then filled by Yeomanry units. The situation remained 
unaltered until the expeditionary force returned from the 
Dardanelles, and the Canal defences came under the command of 
the Mediterranean Expeditionary Force on 24th January 1916. 




'3.28*ee soeo/iti 1500.11 £3 



OPERATIONS IN THE SINAI PENINSULA 411 

Preliminary arrangements were then commenced for moving 
troops east of the Canal. Roads and a Decauville railway 
were pushed on from Kantara towards the Katia district, and 
from Port Said to Mehamdiya on the coast north of Katia and 
Romani, pending the construction of a broad gauge railway. 
Water convoys on camel transport were also organized to 
supply water to the troops until a pipe-line from the Sweet 
Water Canal was laid. At this time the medical arrangements 
were somewhat confused owing to the original Canal defence 
arrangements becoming mixed up with the medical arrange- 
ments of the Dardanelles force then concentrating and being 
reorganized in the Canal Zone. 

The camps were in bad condition, and new camps were 
being occupied east of the Canal before their sanitary 
arrangements were ready, and much work had to be done to 
bring the medical and sanitary services into some kind of 
order for the advance. 

The D.M.S. of the Force for the time being was Surg.-General 
W. G. Bedford, with Colonel Keble as his A.D.M.S., and Colonel 
Melville as A.D.M.S. (Sanitation). Surg.-General Maher suc- 
ceeded Surg.-General Bedford in April 1916, and as the dual 
command in Egypt had then been abolished and Surg.-General 
Ford, the D.M.S. , Egypt, had left, he became the D.M.S. for 
all the military medical services in Egypt and its frontiers, 
with his headquarters at Ismailia. At that time there were 
in Egypt 11,162 hospital beds for British troops, exclusive 
of the accommodation in the Indian and Egyptian hospitals. 
There was also accommodation for 4,646 convalescents. 

In February and March 1916, there were no active hostilities 
beyond reconnaissance of the enemy situation in the Sinai 
Peninsula. 

There was a large number of medical units in the zone, 
many of them in a stage of transfer to other theatres of war. 
They were distributed as follows : — 

Medical Units in the Canal Zone in February 1916. 

Suez Section. 
At Suez .. .. No. 5 Indian General Hospital. 

Nos. 17 and 18 Stationary Hospitals. 
No. 11 Casualty Clearing Station. 
No. 16 Sanitary Section. 
No. 6 Advanced Depot Medical Stores. 
Pathological Laboratory. 

At ShcUlufa . . No. 35 Casualty Clearing Station. 
No. 22 Sanitary Section. 



412 



MEDICAL HISTORY OF THE WAR 



At El Kubri .. No. 14 Casualty Clearing Station. 
No. 30 Sanitary Section. 
" C " Section No. 137 Indian Field Ambulance. 

At El Shatt and Ain Indian field ambulances. 
Musa. 



A t Ismailia 
Moascar. 



and 



At Serapeum 



At Port Said . 



A t Kantara 

At El Ferdan . . 

At Ballah 

At Tel-el-Kebir . . 



Ismailia Section. 
No. 1 Australian Stationary Hospital. 
New Zealand Stationary Hospital. 
No. 2 Australian Casualty Clearing Station. 
No. 8 Base Depot Medical Stores. 
No. 7 Advanced Depot Medical Stores. 
Nos. 24 and 30 Sanitary Sections. 

Two sections No. 124 Indian Combined Field Ambulance. 
Bacteriological Laboratory. 

No. 1 Australian Casualty Clearing Station. 
Australian Sanitary Section. 

Port Said Section. 

No. 31 General Hospital. 

No. 15 Stationary Hospital. 

No. 26 Casualty Clearing Station. 

No. 28 Sanitary Section. 

No. 5 Advanced Depot Medical Stores. 

Bacteriological Laboratory. 

No. 54 Casualty Clearing Station. 
No. 71 Sanitary Section. 

No. 24 Casualty Clearing Station. 
No. 21 Sanitary Section. 

No. 18 Sanitary Section. 

No. 2 Australian Stationary Hospital. 



Field ambulances were with divisions, generally with 
brigades. 

When the Canal Sections were organized for an active 
defence, No. 3 Section based on Kantara became the Mobile 
Column, with Colonel Girvin as D.D.M.S. There were then 
in No. 3 Section or in the Canal area No. 31 General Hospital, 
in the Canal works on the east of the Canal at Port Said, No. 5 
Advanced Depot Medical Stores at Port Said, No. 26 CCS. at 
Kantara East, No. 2 Australian Stationary Hospital at Ismailia 
and No. 24 Stationary Hospital at Moascar. There was a 
sanitary section at Port Said, Kantara and Moascar. Field 
ambulances were with their divisions, the 42nd, 52nd and 
53rd, and mounted field ambulances with the Australian and 
New Zealand Mounted Division, and with the Yeomanry 
brigade, which formed the mobile forces for the advance into 
the Katia district. In April mounted troops were occupying 



OPERATIONS IN THE SINAI PENINSULA 413 

outposts in and beyond Katia,but were attacked on 23rd April 
1916, with the loss of three and a half squadrons of Yeomanry 
at Oghratina and Katia, as already narrated. 

After the enemy attack in April the British line was with- 
drawn to Dueidar, and formed an entrenched position from 
the coast at Mehamdiya to Romani and Katib Gannit, until 
the railway line was sufficiently advanced for a move farther 
east. This was the situation on the 4th August when the 
enemy attacked in force and the battle of Romani was fought. 

The Turks had concentrated in the neighbourhood of Katia 
and on that date attacked the British line from the east, south 
and south-west. Fighting continued till the 12th August, 








J 




-% ' 






w 


jyj 






1 


- W _ d gf*^ 


£ Ijgjj 








^,~^P^ 




'J$L' 


- -> 









Camel cacolets as used in Sinai and Palestine. 



the enemy being driven back with great loss, and forced to 
retire to El Arish. His casualties were estimated as 9,000 
out of a for/e of 18,000. The captures included 4,000 prisoners 
and two Complete field hospitals. 

The situation at the time of the battle was as follows. 
Romani was railhead, being connected by a narrow gauge 
line with the broad gauge line, which had then reached Gilban. 
A narrow gauge branch line also ran from Gilban to Dueidar, 
and another from Mehamdiya to the east bank of the Canal 
at Port Said along the coast. A metalled road had been 
constructed from Kantara to Gilban, and the narrow gauge 
railway was continued along this road as far as Kantara 
alongside the broad gauge. The 42nd Division was on the 
left in the trenches at Mehamdiya and Romani, with one 

(10134; n* 



414 



MEDICAL HISTORY OF THE WAR 



brigade on a hill farther back near Pelusium. A brigade of 
the 53rd Division was north of Romani, and the 52nd Division 
in the trenches between Romani and Katib Gannit. The 
Australian and New Zealand Mounted Division and Yeomanry 
brigade were on the right flank between Katib Gannit and 
Dueidar. The ground over which the battle was fought 
was loose sand and undulating, and the heat excessive, so that 
the men suffered much, especially from thirst. 

Dressing stations were established by the 42nd Division at 
Mehamdiya and Pelusium, and by the 52nd Division at Romani 
railhead and Bir-el-Maler, south-west of it. 




Sand cart as used in Sinai and Palestine. 



The majority of the wounded were in the Australian and 
New Zealand Mounted Division. Its A.D.M.S., Colonel 
R. M. Downes, had four mounted field ambulances with him, 
ihe New Zealand, and 1st, 2nd and 3rd Australian Light 
Horse Field Ambulances. Just before the battle mobile 
sections of these field ambulances were organized with eight 
sand carts each, together with a number of camel cacolets 
and litters and sand sledges. These were to go out with the 
brigades and form advanced dressing stations. The tent 
divisions were immobile and remained in positions farther 
back as main dressing stations : that of the 1st Light Horse 
Field Ambulance at Romani, and that of the 2nd Light Horse 
Field Ambulance at one of the outposts ; they evacuated 
through No. 3 Lowland Field Ambulance of the 52nd Division, 



OPERATIONS IN THE SINAI PENINSULA 415 

which acted as a casualty clearing station at railhead. The 
3rd Light Horse Field Ambulance was on the hill near 
Pelusium, and the New Zealand Mounted Field Ambulance 
formed a main dressing station at Canterbury Post south of 
Pelusium. 

On the 5th August the Light Horse Field Ambulances moved 
forward and collected several enemy wounded, establishing 
dressing stations west of Katia and at Bir Majid, 6 miles 
south of Katib Gannit. A Turkish field ambulance had 
been captured and was kept at Hod el Seifania, about 3 
miles south-west of Katib Gannit, for the collection and 




Camel litters as used during operations in Sinai. 



treatment of the enemy wounded. The New Zealand 
Mounted Field Ambulance went forward to Bir el Nuss, east 
of Dueidar. 

On the 6th August the 5th Mounted Brigade Field Ambul- 
ance of Yeomanry joined the Anzac Mounted Division. It 
opened a dressing station at Katia. Up till then the Yeomanry 
brigade wounded were brought to the Anzac Mounted Division 
or infantry field ambulances. 

The camel ambulance transport of the field ambulances 
was formed into ambulance convoys, which came up and 
cleared the casualties to the 52nd or 42nd Division dressing 
stations on or near the railway. 

The number of casualties received by the Anzac Mounted 
Division field ambulances during the battle and the pursuit 
up to the 13th August is shown in the following table. 



416 



MEDICAL HISTORY OF THE WAR 



Unit. 


Wounded . 


Sick. 


Enemy 
Wounded. 


Total. 


1st Li^ht Horse Field Ambulance 

2nd „ 

3rd 

N.Z. Mounted 

5th ,, Brigade ,, 


150 
334 

72 
141 

43 


40 

247 

52 

38 

147 


18 

129 

10 

1 

22 


208 
710 
134 
180 
212 


Total 


740 


524 


180 1,444 



The total British casualties from all units were 18 officers 
and 204 other ranks killed and 75 officers and 834 other ranks 
wounded. 

There were 16 casualties in the Australian Medical Corps 
personnel, 3 officers were wounded, 1 dying of wounds ; 12 
other ranks were wounded and 1 killed. 

The chief difficulty was the want of a portable stretcher 
for cavalry, resulting in the necessity of bringing sand carts 
and sledges close up to the firing line. The sledges were of 
great value for bringing in the seriously wounded, as were 
also the sand carts. Camel transport was found to be un- 
suitable in front of the main dressing stations, and was only 
used, as noted above, to form ambulance convoys between 
the main dressing stations and railhead. The sand carts 
and sledges were employed between the advanced dressing 
stations near the firing line and the main dressing stations. 

The regimental organization in the Anzac Mounted Division 
broke down, as the regimental stretcher bearers in many 
instances were taken by the commanding officer from the 
control of the regimental medical officer and ordered into the 
firing line. The result was that wounded were carried back 
by untrained men, the medical officers were unable to form 
aid posts under cover, and sand carts had consequently to be 
pushed forward into the firing line. There was also con- 
siderable confusion due to messages reaching the dressing 
station from different sources asking for sand carts to be sent 
up to collect wounded, but when two or more sand carts went 
forward it was to find that all the messages related to one 
wounded man only. These indiscriminate messages were the 
result of the breakdown of the regimental organization and 
they thus caused much unnecessary work both to men and 
horses 

During this battle no hospital trains were sent east of the 
Canal, and the casualties had to be evacuated on open trucks 



OPERATIONS IN THE SINAI PENINSULA 417 

by the light railway from Mehamdiya to Port Said, and from 
Romani railhead and Pelusium to Kantara. No. 31 General 
Hospital on the east bank of the Canal at Port Said received 
the wounded from Mehamdiya, and No. 26 Casualty Clearing 
Station those arriving at Kantara East. The wounded in 
them were evacuated by motor cars from the latter to hospital 
trains at Kantara West or to hospital barges on the Canal, 
and distributed to hospitals in Egypt, chiefly to the Australian 
Stationary Hospital in the Canal Company's school at Ismailia 
and to No. 24 Stationary Hospital at Moascar. 

After the battle the Desert Column, chiefly composed of 
mounted troops, held an advanced line from Bir-el-Abd, 
15 miles east of Katia, southwards to Homossia. The infantry 
returned to the Romani-Mehamdiya positions. 

On the 16th and 17th September a reconnaissance in force 
was carried out by the Desert Column against the enemy 
camp at El Mazar, about 25 miles east of Bir-el-Abd ; the 
casualties were slight. 

After this no important operations were carried out by the 
Eastern Force until the end of 1916, but reconnaissance in 
the Sinai Peninsula continued to be made by cavalry and the 
Bikanir Camel Corps, which reconnoitred for 65 miles east of 
Ismailia on the 13th to 17th October. The railway was 
pushed on to Bir-es-Salmana, 4 miles east of Bir-el-Abd. By 
the 26th November 1916 it had reached El Mazar. Recon- 
naissance was then made to within 3 miles of El Arish. The 
enemy withdrew from El Arish without fighting and that 
town was occupied by the British forces on the 21st December 
1916. 

The chief difficulty of the advance to El Arish was the 
water supply. The pipe-line did not reach Romani till the 
17th November 1916 and water had to be carried forward in 
tank trucks by the railway to fill improvised storage tanks 
at all posts where there was no local water supply. Con- 
sequently before the advance to El Arish water had to be 
accumulated at the railhead. After El Arish had been occupied 
supplies were sent there by sea. 

On the 7th December the Desert Column came under the 
command of Lieut. -General Sir P. Chetwode, who, after the 
occupation of El Arish, pursued the enemy in the direction 
of Magdhaba and El Auja, the former some 20 miles south- 
east of El Arish, and the latter about 25 miles due east 
of Magdhaba. An action was fought at Magdhaba on the 
23rd December 1916 and the post was captured with a loss 



418 MEDICAL HISTORY OF THE WAR 

of 12 officers and 134 other ranks killed and wounded. 
1,282 of the enemy were taken prisoners. A permanent and 
well-equipped hospital was found in Magdhaba. 

The enemy was now in an entrenched position in front of 
and around Rafa, and operations were undertaken by the 
Desert Column on the night of the 8th/9th January 1917 to 
capture it. After considerable resistance, Rafa was occupied 
before 11 a.m. on the 9th January. Fighting was continued 
and the enemy finally driven out of the Sinai Peninsula. 
The number of wounded prisoners captured was 1,600 ; the 
British losses were 71 killed and 415 wounded and 1 missing. 

The railway line was then pushed out along the coast, and 
reached El Arish at the end of January and Rafa in the middle 
of March 1917. 

During the period between the battle of Romani and the 
occupation of Rafa several changes took place in the organiza- 
tion of the medical services and their administration. The 
D.M.S. moved to Cairo from Ismailia with the G.H.Q. of the 
Egyptian Command on the 25th September 1916, and the 
forces composing the Canal Defences and in the Sinai Peninsula 
were formed into an Eastern Force under the command of 
Lieut. -General Sir C. Dobell. The advanced guard of this 
force, composed of mounted troops and an infantry division, 
formed the Desert Column. The Egypt L. of C. was absorbed 
into G.H.Q., and Colonel Sexton, who had been its D.D.M.S., 
was appointed D D.M.S. of the Eastern Force with head- 
quarters at Ismailia. Major Bagshawe was appointed A.D.M.S. 
on his staff. He had under his administrative medical control 
the Canal Sections, each with a D.D.M.S. or A.D.M.S., and 
the D.D.M.S. of the Desert Column. He had also direct 
administrative control over certain hospitals and other medical 
units in all sections of the Canal, and also in the Province of 
Sharquia. The A.D.M.S. for Egyptian Hospitals was also 
under his administrative control. 

When the line advanced the three sections of the Canal were 
divided into a Northern and Southern Section ; the Northern 
Section became the line of communication under the Eastern 
Force from Kantara to railhead. 

In this way there appears to have been more than one 
D.D.M.S. under the administrative control of the D.D.M.S. 
of the Eastern Force. 

There was also apparently, partly under the D.D.M.S., 
Eastern Force, and partly under the D.M.S. at G.H.Q. , the 
D.D.M.S., Indian Troops, who had control of the Indian 



OPERATIONS IN THE SINAI PENINSULA 419 

medical units, no matter where they were placed, and who 
was more especially engaged in directing the evacuation of 
Indians from Egypt to India. 

Colonel C. J. Macdonald, who had been D.D.M.S. of No. 3 
Section of the Canal, was appointed D.D.M.S. of the Desert 
Column, with Major Lelean as his A.D.M.S. Colonel Macdonald 
had had considerable experience of warfare in France, and at 
once commenced to organize the medical services of the Column. 
He introduced systematic and methodical arrangements for 
the work of the medical services in connexion with specific 
operations. For this purpose the G.O.C. of the Column, 
Sir P. Chetwode, kept him fully informed of his plans in advance. 
On the 9th October 1916 he held a conference with the 
A.Ds.M.S. of the Anzac Mounted Division, 52nd Division and 
42nd Division, which then formed the Desert Column Their 
methods had been neither definite nor uniform, and there was a 
tendency to employ horse and camel transport too far forward, 
in some cases almost up to the aid posts. Colonel Macdonald 
consequently arranged that advanced dressing stations should 
be at a distance of from 500 to 2,000 yards, according to the 
nature of the ground, from the aid posts, sufficiently near, 
that is to say, for the R.A.M.C. stretcher bearers to carry 
wounded from the aid posts to the advanced dressing stations, 
and that there should be an animal transport rendezvous 
farther back from which the transport could move forward to 
the advanced dressing stations when circumstances permitted. 
The number of R.A.M.C. stretcher bearers was six squads for 
a brigade, but this was considered insufficient, and the 
D.D.M.S. asked for double that number. Advanced and main 
dressing stations were to be formed by the mobile sections of 
the field ambulances, and ambulance convoys were to operate 
between the dressing stations and railhead, which would never 
be more than 15 miles distant. At railhead a reception hospital 
would be formed by the immobile sections of the field ambu- 
lances, for accommodation and treatment of cases pending 
evacuation by train. In other words, these immobile sections 
were to act as casualty clearing stations. 

Colonel Macdonald considered it best to retain the immobile 
sections of field ambulances at railhead, where they could 
supplement the work of any casualty clearing station that 
might be established there, and at the same time be ready to 
move on camel transport farther forward when necessary. 
The casualty clearing stations were being moved by rail and 
had therefore to remain on the railway line. 



420 MEDICAL HISTORY OF THE WAR 

By the beginning of December four casualty clearing stations 
were placed along the line, No. 24 at Bir-el-Abd, No. 26 at El 
Mazar, and Nos. 53 and 54 at railhead. The last two were kept 
packed ready to move. The accommodation in the two casualty 
clearing stations that were open was for 800, obviously in- 
adequate for a force then numbering some 50,000. Con- 
sequently two stationary hospitals were demanded, one for 
Kantara and the other for Romani. No. 24 Stationary 
Hospital was then moved, in November, from Moascar to 
Kantara East, and No. 2 (Australian) Stationary Hospital 
from Port Said to Mehamdiya instead of to Romani, with the 
accommodation in each increased to 800 beds. 

No hospital trains crossed to the east of the Canal until 
December, when No. 6 and an emergency train were ready, 
the latter being replaced by No. 7 Train on the 14th December. 

The medical situation in the Desert Column, therefore, before 
the advance to and occupation of El Arish was as follows : — 

At Railhead .. The immobile sections of divisional field ambulances, 
with accommodation for 700 casualties. 

At El Abd .. No. 24 Clearing Casualty Station open for 400, Nos. 53 

and 54 Casualty Clearing Stations parked with equipment 
for 200 each. 

At El Mazar .. No. 26 Casualty Clearing Station open for 400. 

At Mehamdiya . . No. 2 (Australian) Stationary Hospital for 800 beds. 

At Kantara East No. 24 Stationary Hospital for 800 beds. 

The total accommodation was, therefore, for 3,500. It was 
less than the number of anticipated casualties, and everything 
depended on the means of rapid evacuation to Kantara and 
Egypt. 

Two hospital trains, Nos. 6 and 7, and equipment for im- 
provising an emergency train were available. Evacuation by 
the Mehamdiya-Port Said route did not prove of much use. 
Mehamdiya had been selected as a hospital centre in order to 
divert evacuation to that route and avoid the more direct 
route to Kantara, as the latter was likely to be congested with 
traffic. The line, however, from Romani to Mehamdiya was 
constantly being blocked by sand drifts, and this interfered 
with its being used as the regular line of evacuation. 

Evacuation by sea was considered, but it was found 
impossible to make use of hospital ships from any point on 
the coast-line of Sinai. 

Extra personnel for loading trains and for work at the 
casualty clearing stations was obtained from bearer sections 
of the Egyptian Labour Corps. These sections were organized 
in July 1916, and trained under the A.D.M.S., Egyptian 



OPERATIONS IN THE SINAI PENINSULA 421 

Hospitals, and the commandant of the Corps. They formed a 
reserve of bearers, who proved to be excellent workers and 
invaluable during the succeeding battles. 

No. 8 Base Depot of Medical Stores was moved to Kantara. 

Changes were effected in order to define the responsibility 
for the medical services. When No. 3 Section of the Canal 
became the Northern Section, its area extending from 
Kantara to Port Said and along the Sinai railway to El 
Arish, the zone in front of El Arish came under the Desert 
Column command. The headquarters of the Northern Section 
was then at El Arish, and the section was administered medi- 
cally by a D.A.D.M.S. (Captain J. H. Wood) under the D.D.M.S. 
of the Eastern Force. His duties were to organize the evacua- 
tion of the sick and wounded along the line and supervise the 
sanitation of the town and camps. These arrangements held 
good until after the Second Battle of Gaza in April 1917. 

For the operations against Magdhaba in December 1916, 
after the occupation of El Arish, medical units were improvised 
to accompany the Imperial Camel Corps Brigade. A mounted 
mobile section was formed from the 1/lst Welsh Field Am- 
bulance of the 53rd Division. The personnel was mounted on 
camels, carrying 48 spare cacolets, and 9 sand carts were 
allotted to the field ambulance. A second camel corps 
ambulance was improvised on the same lines on the 20th 
December. Each camel corps company had in addition a pair 
of cacolets and a medical orderly.* The ordinary ambulance 
transport of a field ambulance mobile section at the time 
consisted of 9 sand carts, 38 cacolets and 10 litters. 

In the Magdhaba action there were 131 wounded, of whom 
30 were serious cases, in the Anzac Mounted Division. In 
addition, 64 enemy wounded, 15 serious, were brought in. 
The railhead was at El Mazar, where No. 26 CCS. was open 
and where No. 54 CCS. had also come up from El Abd, 
together with the immobile sections of the field ambulances. 
Railhead was then some 16 miles across the desert, and in order 
to avoid this journey the D.D.M.S. was anxious to bring the 
wounded to El Arish and send them back by the supply ships. 
The D.M.S., G.H.Q., however, issued an order that no seriously 
sick or wounded should be sent back in these ships. The 

* The Scottish Horse Field Ambulance replaced the ambulance improvised 
from the 1/lst Welsh Field Ambulance on the 9th January 1917. It had 
been sent to Jeddah in August 1916, and had returned to Egypt without dis- 
embarking. Its transport consisted of 18 camel cacolets and 30 litters ; it had 
no sand carts or sledges. 



422 MEDICAL HISTORY OF THE WAR 

slight cases, however, were embarked and sent to No. 31 
Gene